Year: 2024 | Month: April | Volume: 14 | Issue: 4 | Pages: 236-242
DOI: https://doi.org/10.52403/ijhsr.20240434
Functional Outcome of Titanium Elastic Nails in Pediatric Femoral Shaft Fractures
Gaurav Gupta1, Rabins Kumar Sah1, Prashant Thakur1, Robin Yadav1
1Lecturer, Department of Orthopaedics and Traumatology, National medical college and teaching hospital, Birganj, Nepal
Corresponding Author: Gaurav Gupta
ABSTRACT
Introduction: Pediatric femoral shaft fracture is commonest fracture in children. Surgical management of pediatric femur fracture has widened using intramedullary nail, dynamic compression plate and external fixator which have their own merits and demerits. Flexible Intramedullary nailing in the form of titanium elastic nail is one of the best surgical modalities. This technique is considered to be ideal and effective method with least complications and has become increasingly popular in children. The aim of the study was to assess outcome of titanium elastic nail for treatment of femur fracture in children of age group 5-11 years.
MATERIALS AND METHODS: Prospective interventional study was conducted in NMCTH, Birgunj among 35 children of age group 5-11 years who presented with shaft of femur fracture at least 3 cm distal to lesser trochanter and 3cm proximal to distal physis, closed or open fracture with Gustilo Anderson type I and II. Ethical approval was obtained from institutional review committee and proper informed consent was taken. The patients were treated with titanium elastic nail and followed up at 2 weeks, 4 weeks and 6 weeks and then every month till the radiological union was achieved. Data obtained were analyzed in SPSS version 26.0. Flynn criteria was used for final functional outcome.
RESULT: Out of the total 35 cases, the mean age of the patient was 7.71 ± 1.75 years. Majority of the patients 16(45.7%) were of age group 7-9 years. Most of them 24(68.6%) were male whereas 11(21.4%) were female. The study findings showed that more than half 18(51.4%) patients sustained injury due to road traffic accident. Almost equal number of patients had fracture of left side 18(51.4%) and right side 17(48.6%). Majority of the patients 33(94.3%) had closed fracture and transverse fracture 13(37.1%). The mean time taken for surgery was 69.43 minutes ± 14.33 and mean duration of hospital stay was 6.46 days ± 1.01. Majority of them (85.7%) did partial weight bearing crutch walking on 2nd week and (88.6%) did full weight bearing on 6th week. The mean time for radiological union was 10.40 weeks ± 0.81.
Fylnn criteria was used to assess outcome of the treatment, according to which, majority 33(94.30%) reported excellent result and only 2(5.7%) cases reported successful result. Regarding complications, there were no major complications reported, 1(2.9%) case of nail protrusion due to long nail and in 1(2.9%) case superficial infection at nail insertion site which was treated with antibiotic.
CONCLUSION: Titanium elastic nail used for treatment of femur fracture in children of 5-11 years is an acceptable and safest option with minimal complications.
Key words: Paediatrics Shaft of femur fracture, Titanium elastic nail system (TENS), Flexible intramedullary nail, Flynn criteria.