Intramedullary nailing of pediatric femoral fractures with postless technique: technique and early results

This study aims to describe the novel technique of intramedullary nailing of pediatric femoral fractures with a postless distraction technique and to report the technique’s safety, complications, and early clinical outcomes. A retrospective review was performed of pediatric patients at a single urban level I trauma center who underwent femoral nailing using the postless distraction technique. The senior author performed all procedures. We collected the following data for patients meeting inclusion criteria: age, sex, height, weight, BMI, fracture classification, quality of fracture reduction, intraoperative time, length of follow-up, and postoperative complications. There were 17 patients in our study. On average, patients were 14 years old (range 11–17 years) with a BMI of 24.73 kg/m² (19.37–32.66 kg/m²). The mean length of follow-up for all patients was 41 weeks (6–100 weeks). There were no immediate or early postoperative complications during the follow-up of all patients. The use of a postless system allows for accurate, reproducible, and safe management of femoral fractures in the pediatric population. This project demonstrates the safety and feasibility of this technique, even in a child of small stature. Furthermore, pediatric femoral nailing using a postless system has not been previously described in the literature. This is the first study to describe this surgical technique.