Closed reduction and titanium elastic nailing in diaphyseal femoral and tibial fractures in children

Abstract

Purpose: The aim of this study was to evaluate clinical and radiological results of children who were treated using titanium elastic nail (TEN) for femoral and tibial diaphyseal fractures.
 Materials and Methods: A total of 49 (15 female, 34 male) femur shaft fractures (FF group) and 35 (12 female, 23 male) tibial shaft fractures (TF group) were retrospectively analyzed. Time until the operation (in days), duration of hospital stays (in days), time to union (in weeks), and the time to implant removal (in months) were recorded. In the final follow up; limb length discrepancy (mm), angulation, restrictions in the range of hip and knee joint motion were measured. Flynn Score was used for clinical results.
 Results: The mean age was 7.96 in the FF group and 9.34 in the TF group. The mean follow-up time was 51.3 months in the FF Group and 58.3 months in the TF group. The mean duration of hospital stay was 1.4 days in both groups. The mean time for bony union was 9.7 weeks and 10.7 weeks for the FF and the TF groups, respectively. The mean time to implant removal was 7.1 months and 6.22 months for the FF and the TF groups, respectively. Flynn scores were poor in 3 patients, successful in 6 patients and excellent in 40 patients in the FF group; whereas it was poor in 1 patient, successful in 2 patients and excellent in 32 patients in the TF group. None of the patients had major complications. Bony union was achieved in all patients. 
 Conclusion: Intramedullary fixation using TEN is a successful treatment method with satisfactory clinical results and low complication rates for pediatric femoral and tibial diaphyseal fractures.