الفهرس 
AcknowledgmentOnly 14 pages are availabe for public view
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Abstract
Children are at a high risk of injury with up to one of every four children sustaining an injury annually. Fractures are associated with 10% to 25% of these injuries. Femoral shaft fractures reportedly occur at a rate of approximately 20/100,000 children, representing 1.6% of all fractures in the pediatric population. In a Prospective randomized controlled clinical study conducted at the Trauma and Orthopedic Surgery Department at Assiut University Hospital in the period between 2016-2018, Fifty children aged 6-11 years (mean ± SD: 8.12±1.6) with femoral shaft fracture were subjected randomly to surgical fixation of the fracture either by flexible IMNs (group 1) or submuscular locked plating. (group 2). Each group of children had 25 patients. FFH was the major type of trauma in femoral shaft fracture (40%) followed by MCA (24%).According to Gustilo and Anderson classification, fractures fixed by submuscular locked plate were all closed while fractures fixed by flexible IMN were 92% closed and only 8% type 1. Hip spicae were applied to 88% of fractures in group 1 compared Zero% of fractures in group 2. In group 1, only 4 children have residual limited ROM (didn’t reach full flexion companied with the sound side) after 6 months while all children have retained the full knee ROM by the end of follow up period (6 months) in group 2. After 1month, malalignment was noticed in 48% of children in group 1 and not noticed at all in children in group 2. In children subjected to fixation by flexible IMN, weight bearing start after one month in 68% while in children subjected to fixation by submuscular locked plate, 92% started weight bearing after one month. In children in group 1, 24% developed 2 cortices, 36% developed 3 cortices and 40% developed 4 cortices after 1 month postoperative. In children in group 2, 8% developed 2 cortices, 52% developed 3 cortices and 40% developed 4 cortices after 1 month postoperative.