Outcome of Titanium Elastic Nails in Pediatric Femoral Fractures

Abstract

Background: Femoral fractures are common fractures in paediatric age group. There are various methods to treat such cases. Titanium elastic nailing is one of them and an established and reliable method for treating these types of fractures. Ideal treatment of fractures in the age group of 5 to 14 years is still a matter of debate as no consensus has been achieved till now.

Aim of the study: The aim of this study was to evaluate the outcome of using titanium elastic nails (TEN) in pediatric femoral fractures.

Methods: This observational prospective study was conducted in in the Orthopedic Department of Shaheed M. Monsur Ali Medical College, Sirajganj, Bangladesh during the period from January 2017 to December 2018. A group of 50 children with femoral fractures selected to treat with titanium elastic nailing were finalized as the study population. All the information along with the outcomes of the participants were collected assessed and disseminated by several tables and charts of MS Office program.

Result: In 20%, 14%, 4% and 2% cases we found superficial infection, mal-union, deep infection and nail breakage as complication respectively. As the final outcome of this study we found, the results were excellent in 34 patients (68%) successful in 12 (24%) and poor in 4(four) patients (8%) as per the scoring criteria for TEN by Flynn et al. Entry site irritation occurred in 3 patients limb lengthening (<1.5cm) was found in 3 cases both clinically and radiologically, which was clinically insignificant nail removal at 5th month, due to wound breakdown at entry sets in one case. Results were better for children in less than 10 years of age.

Conclusion: Titanium elastic nailing is the method of choice for the simple pediatrics femoral fractures, as it was minimally invasive and showed good functional and cosmetic results. Surgical technique of this procedure is simple and reproducible. It always allows short hospital stay and quick recovery from pain and it is cast-free.