Abstract
Elastic intramedullary nailing or titanium elastic nail (TEN) is an alternative method for the treatment of various pediatric long bone fractures. Titanium nails are preferred over plaster cast and stainless steel nails for children older than six years. Our series included 30 paediatric long bone fractures who were managed with TEN. The mean age was 9.3 years and the mean follow-up period was 28 months. A mean time of 10 weeks was recorded for the union of all fractures. The occurrence of superficial infection in three cases healed with antibiotics and minor debridement. Limb length discrepancy was seen in three cases of femur fracture, which was functionally insignificant, but it may be a potential problem needing close follow-up until skeletal maturity is attained. An elastic intramedullary nail or TEN in long bone fractures in children is a safe and minimally invasive technique that achieves stable reduction, especially in long spiral fractures till union. We attained successful union and good results in all our 30 cases with long bone fractures in children. A few complications of hardware prominence were resolved with implant removal. Long-term studies with a comparison to casting techniques in paediatric long bone fractures are required.
Highlights
The constantly evolving methods of treatment of fractures in long bones in children have shown a preference for the use of intramedullary elastic nails
Plaster casting for the fracture of long bones in children less than six years and intramedullary nailing in adolescent above 16 years was suggested by Metazziau
Elastic intramedullary nailing was preferred in older children due to poor tolerance of immobilization and an uncomfortable cast
Summary
The constantly evolving methods of treatment of fractures in long bones in children have shown a preference for the use of intramedullary elastic nails. The majority of the long bone fractures in the skeletally immature is being treated by conservative methods. Plaster casting for the fracture of long bones in children less than six years and intramedullary nailing in adolescent above 16 years was suggested by Metazziau. Various methods of fixation are available for the stabilization of long bone fractures in children, the introduction of flexible elastic nails has changed the management for shaft-of-femur fractures in children significantly [4,5]. Many other intramedullary nails, such as Rush nails and Ender’s nails, are available for the treatment of long bone fractures in children, but they lack rotational stability. The management of femur fractures in the paediatric age group of up to six years is mostly conservative, but we used a titanium elastic nail (TEN) in the management of all long bone fractures in children more than the age of six years and less than 15 years and share our experience to add to the evidence in the management of long bone fractures in the paediatric age group [5,6]
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