Use of Titanium elastic nailing in children 6-16 years of age with femoral diaphyseal fractures

Abstract

Background: Significant controversy continues regarding the best methods of treating paediatric femoral shaft fractures. Over last 3 decades, operative management of paediatric femoral shaft fractures in age group 6-16 years has been gaining popularity. Titanium Elastic Nailing has now become the choice of fixation in femoral shaft fractures in this age groups. Objective: To evaluate the results of titanium elastic nailing system (TENS) in paediatric femoral diaphyseal fractures of children aged 6-16 years. Material and Methods: 32 patients (19 boys, 13 girls) in the age range of 6-16 years (average 10.2 years) with recent (< 5 days) femoral shaft fractures (23 closed, 7 Grade- I and 2 Grade- II Gustilo Anderson compound) were fixed with TENS. Evaluation was done on the basis of clinical and radiological evidences. The results were judged using Flynn’s scoring criteria. Results: Primary union was achieved in all patients without any rotational deformity. Mean operation time was 68 minutes. The results were excellent in 24 patients (75%) and successful in 8 patients (25%). There were 4 cases showing entry site irritation and 2 cases showing superficial infection. Functional outcome was good for those who achieved union. Conclusion: It was seen that excellent level of bone union was achieved by performing tens nail fixation in paediatric femoral fractures.Elasticity of nail provided enough counterforce to the muscular forces. TEN is an effective treatment option in selected cases of femoral diaphyseal fractures in the 6-16 years age group.