Pediatric long bone fractures treated by elastic intramedullary nailing
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20214175Keywords:
Elastic stable intra-medullary nailing, Long bone, Diaphyseal fractures, PediatricAbstract
Background: Pediatric long bone fractures can have a high morbidity and long term disability among the survivors. The present study was aimed to study the clinical outcomes of children with long bone fractures managed by elastic intramedullary nail.
Methods: We retrospectively reviewed the medical records of children (aged 2 to 15 years) who were admitted and treated for unilateral femoral, tibial or forearm fractures with elastic intramedullary nail from January 2018 till February 2020. All were managed with elastic intramedullary nailing. The union times and complications were noted from the medical records.
Results: Femoral, tibial and forearm bones were involved in 15 patients each (33.3%). Road traffic accident was reported by 31%) and physical abuse by one case (2%). The mean time of union was 10 weeks, ranging from 6 to 12 weeks. The mean time for union of the femur and tibia was 11.54 and 11.34 weeks respectively. It was significantly lower for forearm (6.67 weeks, p value <0.05). Two patients reported of bursitis and impingement, which were resolved after nail removal. One case had limb length discrepancy of about 0.5 cm in femur fracture, which was not impairing functional activity. Functional status was assessed based on Flynn criteria was found to be excellent in 36%, good in 44% and fair in 20%.
Conclusions: The results of the present study show that titanium elastic nail (TEN) is an effective treatment modality for managing pediatric long bone fractures. We recommend the use of TEN in managing long bone fractures in children.
References
Walsh SS, Jarvis SN, Towner EM, Aynsley-Green A. Annual incidence of unintentional injury among 54,000 children. Inj Prev. 1996;2(1):16-20.
Landin LA. Epidemiology of children’s fractures. J Pediatr Orthop B. 1997;6(2):79-83.
Valerio G, Galle F, Mancusi C, Di Onofrio V, Colapietro M, Guida P, Liguori G. Pattern of fractures across pediatric age groups: analysis of individual and lifestyle factors. BMC Public Health. 2010;10:656.
Lee SS, Mahar AT, Nowton PO. Ender nail fixation of pediatric femur fractures. A biomechanical analysis. J Pediatr Orthop. 2001;21:442-5.
Li Y, Stabile KJ, Shilt JS. Biomechanical analysis of titanium elastic nail fixation in a pediatric femur fracture model. J Pediatr Orthop. 2008;28:874-8.
Flynn JC, Mathews JG, Benoit RL. Blind pinning of displaced supracondylar Fractures of the humerus in children: Sixteen years experience with long term follow up. J Bone Joint Surg Am. 1974;56:263-72.
Raut S, Jain D, Gohil P, Malviya P, Vieira A, Agrawal T. Prospective study of management of long bone fracture by intra-medullary elastic nailing in children. Int J Res Orthop. 2020;6:353-9.
Lakavath V, Reddy KR, Rathod J. A study of pediatric long bone fracture treatment using elastic titanium nails. Int J Contemp Med Res. 2017;4(7):1431-2.
Khuntia S, Swaroop S, Patro BP, Sahu S. Paediatric Long Bone Fractures Managed with Elastic Intramedullary Nails: A Retrospective Study of 30 Patients. Cureus. 2020;12(4).
Gavaskar B, Singh R. Management of diaphyseal long bone fractures in paediatric age group by TENS. Int J Orthop Sci. 2020;6(1):460-3.
