Titanium elastic nailing for paediatric femoral shaft fractures: a prospective descriptive study

Authors

  • Santosha . Department of Orthopaedics, Shimoga Institute of Medical Sciences, Shimoga, Karnataka
  • Shams Gulrez Department of Orthopaedics, RIMS, Imphal, Manipur

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20171892

Keywords:

TENS, Femoral fracture, Intramedullary nailing, ESIN

Abstract

Background: Femoral shaft fracture is the most common major paediatric orthopaedic fractures. For generations traction and casting was the standard treatment for all femoral shaft fractures in children. Over the past two decades the advantages of fixation and rapid mobilisation have been increasingly recognised. Aim: To assess the functional and clinical outcome after closed reduction and internal fixation with titanium elastic nail in diaphyseal femoral fractures between 5 to 16 years.

Methods: The study was conducted in the Department of Orthopaedic Surgery, Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, from September 2013 to April 2015. Thirty children (20 boys and 10 girls) in the age group of 5 to 16 years with recent femoral diaphyseal fractures were stabilised by titanium elastic nails [TENS]. Results were evaluated according to Flynn’s scoring criteria.

Results: After 25 months of follow up all thirty patients were available for evaluation. Radiological union were achieved in a mean time of 11.5 weeks. Mean duration of hospital stay was 15.23 days. According to Flynn’s criteria of TENS outcome score results were excellent in 66.7% patients, Satisfactory in 30% patients, Poor in 3.3% patient. All patients had early return to school. Per operative technical problems included failure of closed reduction in 2 cases.

Conclusions: Titanium elastic nailing is an effective treatment in diaphyseal fractures of femur in properly selected patients. 

Author Biography

Santosha ., Department of Orthopaedics, Shimoga Institute of Medical Sciences, Shimoga, Karnataka

SENIOR RESIDENT

References

Viljanto J, Linna MI, Kiviluoto H, Paananen M. Indications and results of operative treatment of femoral shaft fractures in children. Acta Chir Scand. 1975;141(5):366-9.

Saikia KC, Bhuyan SK, Bhattacharya TD, Saikia SP. Titanium elastic nailing in femoral diaphyseal fractures of children in 6-16 years of age. Indian J Orthop. 2007;41(4):381-5.

El-Adl G, Mostafa MF, Khalil MA, Enan A. Titanium elastic nail fixation for paediatric femoral and tibial fractures. Acta Orthop Belg. 2009;75(4):512-20.

Ligier JN, Metaizeau JP, Prevot J. Closed flexible medullary nailing in paediatric traumatology. Chir Pediatr. 1983;24:383-5.

Li Y, Stabile KJ, Shilt JS. Biomechanical analysis of titanium elastic Nail fixation in a pediatric femur fracture model. J Pediatr Orthop. 2008;28(8):874–8.

Mahar A, Sink E, Faro F, Oka R, Newton PO. Differences in biomechanical stability of femur fracture fixation when using titanium nails of increasing diameter. J Child Orthop. 2007;1(3):211–5.

Pogorelic Z, Furlan D, Biocic M, Juric I, Budimir D, Todoric J, et al. Titanium intramedullary nailing for treatment of simple bone cysts of the long bones in children. Scott Med J. 2010;55(3):35–8.

Wall EJ, Jain V, Vora V, Mehlman CT, Crawford AH. Complications of titanium and stainless steel elastic nail fixation of pediatric femoral fractures. J Bone Joint Surg Am. 2008;90(6):1305–13.

Flynn JM, Skaggs DL, Sponseller PD, Ganely TJ, Kay RM, Kellie Leitch KK. The operative management of pediatric fractures of lower extremity. J Bone Joint Surg Am. 2002;84:2288-300.

Flynn JM, Hresko T, Reynolds RA, Blaiser RD, Davidson R, Kasser J. Titanium elastic nails for pediatric femur fractures: a multicenter study of early results with analysis of complications. J Pediatr Orthop. 2001;21(1):4-8.

Flynn JM, Luedtke LM, Ganly TJ, Dawson J, Davidson R, Dormans JP, et al. Comparison of Titanium Elastic Nails with Traction and a Spica Cast to Treat Femoral Fractures in Children. J Bone Joint Surg Am. 2004;86(4):770-8.

Ramachandra K, Virupaksha Reddy SP, Gahlowt A, Akshay SD, Javali V, et al. A prospective study of management of pediatric femoral diaphyseal fractures using intramedullary titanium elastic nails. Int J Res Health Sci. 2015;3(1):11-7.

Moroz L, Launay F, Kocher MS, Newton PO, Frick SL, Sponseller PD, et al. Titanium elastic nailing of fractures of the femur in children: predictors of complications and poor outcome. J Bone Joint Surg Br. 2006;88(10):1361-6.

Bhasker A. Mumbai treatment of long bone fractures in childrens by titanium elastic nailing. Ind J Orthop. 2005;39(3):166-8.

Bandyopadhyay R, Mukherjee A. Short Term Complications of Titanium Elastic Nail in the Treatment of Diaphyseal Fracture of the Femur in Children. Open Orthop J. 2013;7:12-7.

Singh R, Sharma SC, Magu NK, Singla A. Titanium elastic nailing in pediatric femoral diaphyseal fractures. Ind J Orthop. 2006;40(1):29-34.

Singh P, Kumar R. Pediatric femoral shaft fracture management by titanium elastic nailing; a prospective study of 112 patients. The Internet J of Ortho Sur. 2012;19(3):1-7.

Gross RH, Davidson R, Sullivan JA, Peeples RE, Hufft R. Cast brace management of the femoral shaft fracture in children and young adults. J Pediatr Orthop. 1983;3(5):572-82.

Khazzam M, Tassone C, Liu XC, Lyon R, Freeto B. Schwab J, et al. Use of Flexible Intramedullary Nail Fixation in Treating Femur Fractures in Children. Am J Orthop. 2009;38(3):49-55.

Ferguson J, Nicol RO. Early spica treatment of pediatric femoral shaft fractures. J Pediatr Orthop. 2000;20(2):189-92.

Herndon WA, Mahnken RF, Yngve DA, Sullivan JA. Management of femoral shaft fractures in the adolescent. J Pediatr Orthop. 1989;9(1):29-32.

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Published

2017-04-25

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Original Research Articles