{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T08:47:40Z","timestamp":1775810860689,"version":"3.50.1"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Femoral shaft fractures in adolescents are commonly treated with either antegrade intramedullary nailing (AIN) or lateral plate (LP) fixation. This study compared the clinical outcomes of these two methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adolescent patients with femoral shaft fractures were randomly assigned to either the AIN group (<jats:italic>n<\/jats:italic>\u2009=\u200962) or the LP group (<jats:italic>n<\/jats:italic>\u2009=\u200962). Surgical parameters, early recovery metrics, levels of inflammatory cytokines, pain mediators, and bone metabolism markers were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The AIN group had significantly shorter incision lengths (6.8 vs. 8.5\u2005cm, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001) and lower intraoperative blood loss (120 vs. 170\u2005ml, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001) compared to the LP group. AIN patients began weight-bearing activities earlier (34 vs. 47 days, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.01). Three months post-operation, the AIN group showed superior proximal femoral geometry and hip function, with a higher non-arthritic hip score (NAHS, 87 vs. 75, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001). One-week post-operation, the AIN group had lower serum levels of inflammatory cytokines and pain mediators, indicating a reduced inflammatory response and less postoperative pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>AIN offers significant advantages over LP in treating adolescent femoral shaft fractures, including reduced surgical trauma, faster early recovery, lower inflammatory response, less postoperative pain, and enhanced bone healing.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2025.1614146","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T05:26:06Z","timestamp":1752729966000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative analysis of adolescent intramedullary nailing and locking plate fixation for femoral shaft 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