Retrospective Evaluation of the Results of Elastic Intramedullary Nailing in Pediatric Femoral, Tibial, and Forearm Diaphyseal Fractures

Abstract

Objective: In this study, we aimed to evaluate the clinical and radiological outcomes of pediatric femur, tibia, and diaphyseal fractures treated with elastic intramedullary nails.Method: Overall 50 patients (34 male and 16 females; mean age: 7.7 years; range 5–14 years) diagnosed with femur, tibia, and forearm diaphyseal fractures were treated with titanium elastic nails (TEN). Of these, 18 were femur, 16 were tibia, and 16 were forearm diaphyseal fractures. One femoral shaft fracture was fragmented, and one tibia fracture was an open fracture. Open reduction was performed in two patients, whereas closed reduction was performed in the other patients. Anteroposterior (AP) and Lateral radiographies were used in the follow-up of patients. The patients were evaluated according to the range of motion, ability to use extremities, hospitalization duration, union duration of the fractures, inequality that may occur in the extremities, and development of complications. Flynn scoring system was used for evaluating the cases.Results: Union of the fractures was achieved in an average of 6.9 (range: 4–11) weeks.A patient had a tibia fracture in the front-back plane AP with 5 varus angulation, 10 posterior angulation with a forearm fracture in the lateral plane, and 2.5 mm shortness was observed in an another forearm fracture. All patients, except one, had normal range of motion and could comfortably use the extremities. No nonunion, epiphysial growth arrest, and infection was observed in any patient. According to the Flynn criteria; perfect results were achieved in 34 patients and successful results were achieved in 16. Average union duration was 9.6 (range: 5–14) weeks, hospitalization duration was 3.5 (range: 3–6) days, and follow-up duration was 12.4 (range: 6–19) months. Conclusions: Titanium intramedullary elastic nail is a treatment method that can be successfully performed on pediatric femur, tibia, and forearm diaphyseal fractures.