Abstract
Titanium elastic nail (TEN) as an alternative to traction and spica cast in preschool children has not been widely studied for its safety and effectiveness. A cohort of 59 children with 59 fractures (non-pathological; not involving condyles or cervicotrochanteric area) were retrospectively examined. Their mean age was 4.5±0.9years and their mean weight was 14.5±3.7kg. All but five were closed (21 transverse, 19 oblique and 19 spiral). Thirty-five were caused by motor vehicle accidents and 24 by falls. There were six upper third, 27 upper-middle junction, 14 middle third, seven lower-middle junction, and five lower third fractures. The mean follow-up was 41.8±4.3months, the mean hospital stay was 1.3±0.87days, and the mean time to nail removal was 20.3±10.2weeks. The mean time to union was 7.6±1.5weeks. Union was significantly correlated to age (p=0.000) and fracture shape (p=0.005), but not to the fracture level, nature, or mechanism. Shortening of ≥1.0cm occurred in two cases (3.4%), with an overall mean of 0.06±0.21cm. Shortening was significantly correlated to the fracture shape (p=0.020), but not to the level. Overgrowth of ≥1cm occurred in seven cases (11.9%), with an overall mean of 0.22±0.41cm. Overgrowth was insignificantly correlated to the fracture level and shape. Frontal angulation of 5-9º occurred in six cases (10.2%) and sagittal angulation of 3-7º occurred in seven cases (11.9%). A rotational deformity of 10º occurred in two cases (3.4%). Five cases had a painful nail end (8.5%) and exteriorization with superficial infection occurred in two cases (3.4%). TEN is a dependable, safe, and cost-effective alternative to traction and cast in preschool children.
Highlights
IntroductionMany treatment options are reported for school age children [1, 2], but only five papers addressed the problem in preschool children, with three of them about titanium elastic nail (TEN) [3,4,5,6,7]
Femur fracture is among the most common and most disabling injuries in childhood
Many treatment options are reported for school age children [1, 2], but only five papers addressed the problem in preschool children, with three of them about titanium elastic nail (TEN) [3,4,5,6,7]
Summary
Many treatment options are reported for school age children [1, 2], but only five papers addressed the problem in preschool children, with three of them about titanium elastic nail (TEN) [3,4,5,6,7]. The treatment options for preschool femur fractures include immediate [8] or delayed spica cast immobilization [9], skin or skeletal traction on a splint [10], plating [11], elastic nail [9], and external fixators. The most commonly used treatment for preschool children are spica cast immobilization and traction These produce very good union rates [2, 10], they mean delayed weight-bearing, late return to school, and impose psychological burden on the child [12, 13]. This study hypothesized that TEN produces good results in treating femur fractures in preschool children in both the short and the long term and avoids the complications due to traction and spica cast
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
