Analysis of pediatric diaphyseal femoral fracture treated with titanium elastic nailing system

Abstract

With many modalities available in literature to treat a pediatric femur diaphyseal fracture, it often creates a debate amongst the orthopedicians to choose a treatment of choice. The frequency of such fractures is increasing over the years due to increasing road traffic accidents. Until recently the conservative management was the preferred method to treat such injuries, however because of advantages such as early mobilization, reduced hospital stay, reduced loss of school days, less psychological impact and better nursing care, Titanium elastic nailing system (TENS) has gained the popularity over last two decades. In north eastern region of India to the best of our knowledge, no such study has been done to assess the functional outcome of TENS in pediatric femur diaphyseal fracture in age group of 6-11 years. Hence we retrospectively analysed the result of pediatric femoral diaphyseal fractures in 32 children (23 boys and 9 girls) in the age group of 6-11 years stabilized with titanium elastic nail (TEN).Results: Using Flynn criteria, outcome was excellent in 90.62% (n=29) children and satisfactory in 9.27% (n=3) children at the final follow up period of 6- 8 months after operation. Patients achieved union over a mean period of 8 weeks. Pin site irritation was found in 12.5% (n=4) patients initially which later subsided with physiotherapy at final follow up (6 months). No cases with superficial or deep infection were reported. No child reported any rotational or sagittal plane deformities.Conclusion: Titanium elastic nailing system provides an effective mode of treatment in pediatric femoral diaphyseal fracture in the age group of 6-11 years with advantages of early mobilization and union.