Outcome of femoral shaft fracture in paediatric age group with titanium elastic nail

Dinesh Kumar Bairwa; Ankur Agarwal; Anand Kumar; Sanjay Gujjar

doi:10.18203/issn.2455-4510.IntJResOrthop20253424

Authors

Dinesh Kumar Bairwa Department of Orthopaedics, RVRS Medical College, Bhilwara, Rajasthan, India
Ankur Agarwal Department of Orthopaedics, Government Medical College, Kota, Rajasthan, India
Anand Kumar Department of Orthopaedics, Government Medical College, Kota, Rajasthan, India
Sanjay Gujjar Department of Orthopaedics, Government Medical College, Kota, Rajasthan, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20253424

Keywords:

Elastic nail, Femur shaft, Flynn criteria, Intramedullary nailing

Abstract

Background: Femoral shaft fractures are among the most serious and disruptive injuries in children, not only physically but also emotionally—for both the child and their family. Traditionally, such fractures were treated with conservative methods like traction and casting. However, with evolving medical practices and increasing emphasis on early mobility, surgical options like titanium elastic nailing system (TENS) have become more popular, especially in older children.

Methods: This prospective study was conducted at Government Medical College, Kota, between December 2022 and November 2023, involving 30 children aged 4 to 14 years with femoral shaft fractures treated using TENS. We evaluated healing time, complication rates, functional outcomes, and overall effectiveness of this technique.

Results: Most fractures (96%) were managed successfully with closed reduction. The average time to fracture union was 8 weeks, and most children could bear full weight by that time. By 12 weeks, nearly 90% regained full range of knee movement. Minor complications like skin irritation and superficial infection occurred in a few cases but were easily managed. Importantly, no child developed severe complications such as delayed union, non-union, or avascular necrosis.

Conclusions: Using Flynn's criteria, 87% of children had excellent outcomes, while the rest had satisfactory results. No poor outcomes were observed. Our findings suggest that TENS is a safe, minimally invasive, and highly effective method for treating femoral shaft fractures in children, allowing quicker recovery, early mobility, and a return to normal life with minimal complications.

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