Flexible intramedullary nail fixation for paediatric tibial diaphysis fractures

Abstract

Background and objectives:Paediatric tibial diaphysis fractures were usually treated by conservative treatment with- out surgery. Nowadays, flexible intramedullary nails are frequently used in these fractures. The aim of this study was to assess the outcome of this technique and to evaluate the results regarding the union rate and postoperative com- plications. Methods:This study included 48 patients aged between 5 and 15 years. Forty-six cases had unilateral tibial diaphysis fractures and 2 cases had bilateral fractures. All the patients were treated with closed flexible intramedullary nailing. The study was done prospectively over a period of 2.5 years in West Erbil Emergency Hospital with a minimum follow up of 6 months. Results: In our study, the mean age was 8.8 years. The participants consisted of 36 patients (72%) males and 14 (28%) females. Fractures of the distal third of the tibial diaphysis were the most common and accounted for 31 cases (62%), those with middle third fracture were 19 cases (38%) and the upper third were 4 cases (8%). All patients got union with an average of 11 weeks. Nail protrusion and skin irritation were the most common complications, found in 10 patients (20%), and reoperation was done in three of them by cutting tip of the nail. Conclusion:Flexible intramedullary nails are effective and minimally invasive method for treatment of paediatric tibial diaphysis fractures; they control the length, angulations and rotation, as they provide stability through three points of fixations for each nail.