The growing number of children suffering polytrauma from traffic accidents dictates the expansion of the indications for osteosynthesis. Elastic-stable intramedullary osteosynthesis (ESIN) is the optimum treatment of fractures of long bones in children.

Closed intramedullary osteosynthesis of diaphyseal femur fractures with flexible nails was performed in 74 patients (76 fractures) during 2006–2010. The patients were children ages 1–8 years. Titanium elastic nails (TEN) (Synthesis, Switzerland) were used in the procedures. AO Foundation recommendations were adhered to when selecting the size of the implant (i.e., diameter approximately 1/3 the diameter of the femur medullar canal at its narrowest part).

There was a prevalence (n = 53) of simple fractures (Ð3 by AO classification) in this group of patients. Sixteen children had Ð2-type fractures, five with spiral (Ð1), and two with slanting (Ð2) fractures. There were no type Ð1 or Ð3 complex fractures in this group. Good functional results of closed intramedullary osteosynthesis with TEN at diaphyseal fractures of the femur in children with isolated and associated damages were achieved. There were no post-operative complications. This method provided stability of osteosynthesis, which allows activating patients in the short- term, i.e., during the post-operative period.

Treating femur fractures in children with ESIN provides optimum treatment of polytrauma. Osteosynthesis without exposure to the area of damage, and the early activation of children can prevent infectious complications and contractures.