KUMJ | VOL. 13 | NO. 3 | ISSUE 51 | JULY-SEPT. 2015
Outcome of Titanium Elastic Intramedullary Nail in the Treatment of Shaft of Femur Fracture in Children.
Khan JA, Singh GP, Pandey A
Abstract: Background
Femoral-shaft fractures are among the most common fractures of the lower
extremity in children. There are several different options for treating femoral-shaft
fractures in children. Elastic stable intramedullary nailing (ESIN) has become the
standard treatment for fractures of shaft of femur in children for reasons including
mini-invasive surgery, no need for casting, early mobilization and discharge as well as
growing concerns toward cost-effectiveness.
Objective
To demonstrate the effectiveness of intramedullary fixation of fracture shaft of femur
in skeletally immature children using the titanium elastic intramedullary nails.
Method
Forty children who underwent fixation with titanium intramedullary nails because of
fracture of shaft of femur (Winquist and Hansen type 1 and 2) were reviewed. There
were 60% male and 40% female patients and mean follow-up was six months. Time
of union, deformity at fracture site, limb length discrepancy, knee range of motion
and complications were assessed.
Result
Average age of the patients was 5.17 years (range 3 to 10). All patients achieved
complete healing at a mean 12.8 weeks (range 10 to 20 weeks). Average limb length
discrepancy was -0.16 cm (range -1.0 to 1.1 cm) average knee range of motion was
137.55 degrees (range 118 to 152 degrees). Complications were recorded in 13
(31.7%) patients and included: Five malunion which did not show any deformity or
functional impairment and eight superficial wound infections which were healed
after removal of nail. All patients were active as their pre injury levels at six months
follow up.
Conclusion
Elastic stable intramedullary nailing is the method of choice for the simple pediatrics
fracture shaft of femur, as it is minimally invasive and shows good functional and
cosmetic results. It allows short hospital stay and quick recovery from pain and is
cast-free.
Keyword : Children, fracture shaft of femur, titanium elastic nail (TEN).
