~ 197 ~ International Journal of Orthopaedics Sciences 2023; 9(2): 197-199 E-ISSN: 2395-1958 P-ISSN: 2706-6630 IJOS 2023; 9(2): 197-199 © 2023 IJOS www.orthopaper.com Received: 09-02-2023 Accepted: 10-03-2023 Deya AlWadi Department of Orthopedic, Royal Medical Services, Amman, Jordan Ahmad Almigdad Department of Orthopedic, Royal Medical Services, Amman, Jordan Corresponding Author: Deya AlWadi Department of Orthopedic, Royal Medical Services, Amman, Jordan Usage of elastic intramedullary nailing in highly unstable pediatric femur shaft fracture: A case report Deya AlWadi and Ahmad Almigdad DOI: https://doi.org/10.22271/ortho.2023.v9.i2c.3368 Abstract Femoral shaft fractures are the leading cause of hospitalization for pediatric fractures, and their treatment is controversial and depends on many factors, including the child's age, weight, anatomical site, type of fracture, joint involvement, soft tissue conditions, and associated injuries. Treatment modalities of pediatric femoral fractures include non-operative options like palvic harness and spica casting, usually utilized in younger age groups, while surgical options like nailing and plating are used in older age groups. This paper reports an 8-year-old male with a long spiral femur shaft fracture treated with elastic nailing. Keywords: Femur, Fracture, Intramedullary nail, Pediatric. Introduction Femoral shaft fractures represent less than 2% of all pediatric fractures. However, they are the leading cause of hospitalization in children [1, 2] . Many factors play a role when treating pediatric femoral shaft fractures, including the child's age, the patient's weight, the type of fracture, associated injuries, and the family's socioeconomic status. Nevertheless, many controversies exist in treating such fractures in the age group 5-16 years, with no consensus about the best option. Conservative options can be considered in the younger ages. However, surgical options, including external fixation, plating, and intramedullary nailing, are usually indicated in this age category [3] . Case presentation An 8-year-old male presented to the emergency department late at night after falling from a one-meter height while playing inside the home and developed immediate pain and gross deformity of the right thigh. Clinical examination revealed an isolated right closed thigh injury with gross deformity associated with moderate swelling, mild ecchymosis, palpable distal pulses, and intact neurological function distal to the injury. The thigh radiograph demonstrated a long spiral right femur shaft fracture, figure 1. Accordingly, skin traction with 5 kilograms was applied. Fig 1: Initial X-rays at the time of presentation.