Comparison of Clinical Outcomes of Flexible Intramedullary Nailing (FIN) with External Fixation in Pediatric Open Tibial Fractures

Abstract

Objective: To compare the clinical outcome of flexible intramedullary nailing (FIN) with external fixator in pediatric open tibial fractures. Subjects and Methods: In this randomized comparative study, 80 children having age 5 year to 14 years who presented with open tibial fractures were included. The study was conducted from June-2020 to June-2021 in Islam Hospital Sialkot and Allama Iqbal Memorial Hospital Sialkot. Patients were divided into two equal groups. Group A: underwent external fixation and group B: underwent flexible intramedullary nailing for the surgical management of tibial fractures. Frequency of infections surrounding pins, painful bursitis and re fracture rate within 3 months after surgery was recorded. Results: The mean age of children was 8.42±3.82 years in external fixator group versus 8.40±4.0 years in FIN group (p-value 0.97). Infection-surrounding pins occurred in 9 (22.5%) children were belonging to external fixator group and 01 (2.5%) children was belonging to FIN group (p-value 0.007). Refracture occurred in 6 (15.0%) patients in external fixator group and in no (0.0%) children in FIN group (p-value 0.01). Painful bursitis occurred 2 (5.0%) patient was in external fixator group and in 13 (32.5%) in FIN group (p-value 0.002). Conclusion: Clinical outcome is better in patients treated with FIN as compared to the external fixator for the treatment of pediatric open tibial shaft fractures. Keywords: Flexible intramedullary nails, External fixator, Tibial fractures.