IF NEEDED TO BE SURGICALLY INTERVENED UPON, IN THE PAEDIATRIC DIAPHYSEAL FRACTURES, WHICH IS THE BETTER AMONG THE AVAILABLE FIXATION DEVICES-A CASE SERIES CONSIDERATION.

Abstract

Humeral fractures, in the paediatric age group, have two peaks of incidence. It has a high incidence in babies below three years of age, and again also in children, above 10 years of age. The objective of our study, was to compare the most popular operative techniques for handling humeral diaphyseal fractures, in the paediatric age group, such as Plate Osteosynthesis (Locking Compression Plate), Elastic Stable Intramedullary Nailing System (ESIS), and the External Fixation devices (EF). This prospective study was conducted at Chettinad Hospital and Research Institute (CH&RI), Kelambakkam, from July 2017 to June 2020. A total of 15 patients were a part of this study, of which, 8 were males and 7 were females. The functional outcomes were assessed using the DASH, the Borberg and Morrey scoring system and the radiographic assessment was done using Stan's Radiographic Grading system, in all the three methods of treatment. The Follow up period was for a minimum of twelve months. The Broberg and Morrey Score points were 88.4 (74-95) for LCP, 80.67 for ESIS (70- 91) and 83.87 (80-87) for EF (p value>0.05). In the DASH score, the average was 19.2 in the LCP group, 21.17 and 21.10, respectively, in the ESIS and EF groups. Stan's Radiographic Grading showed Grade 2 to 3 fracture union status, in all the xation modalities of our study. The prudence of the surgeon, his surgical experience, the age of the patient, the geometry of the fracture and the nature of the humeral diaphyseal fracture, all needs to be carefully weighed, analyzed and on a case-to-case basis, the decision has to be taken, regarding which xation device is best suited for that very particular fracture. All the three modalities have been showcased to highlight their pros and cons, not with-standing the fact that, all the three modalities have faired superiorly in giving good to excellent result outcomes.