Limb length discrepancy following titanium elastic nailing in paediatric femoral shaft fractures

The authors performed a prospective study to evaluate limb length discrepancy in children following titanium elastic nailing for femoral shaft fractures. Thirty-seven children (28 boys and 9 girls) were included in the study. The average time to radiological union in our study was 7.8 weeks (range: 5 to 14). Results after 3 years were evaluated for 29 children. Limb lengthening was noted in the first year in 15 children: at the time of nail removal, an average of 10.6 mm and at the end of one year 8.7 mm. After three years only nine were lengthened an average of 2.7 mm. An average of 12.6 mm shortening was seen in four patients at the time of nail removal, reduced to 12.1 mm at the end of one year. After three years three remained short, an average of 11.7 mm. No limb length discrepancy was seen in 10 patients. We conclude that limb length discrepancy is common following elastic nailing in paediatric femoral fractures, with lengthening being more frequent than shortening. Lengthening tends to decline with time at an average rate of around 1.5 mm per year.