Role of Closed intramedullary Titanium Elastic Nailing in Fracture Shaft Femur in Children


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Article type :

Original Article

Author :

V.P. Pathania, Saurabh Arora, Sanjay Gupta

Volume :

3

Issue :

2

Abstract :

Introduction: Fracture shaft femur is a common injury in children. The best treatment for children between 5 to 14 years of age is still debatable. The ideal device for the treatment of most displaced femoral fractures in children would be a simple, load-sharing internal splint that allows mobilization and maintenance of alignment and extremity length until bridging callus forms. Titanium elastic nails offer these features. Aim and Objectives: To assess the functional and radiological outcome of closed reduction and internal fixation of fractures of shaft femur in children aged 5-14 years with TENS. Materials and Methods: 30 patients were treated from November 2014 to July 2016 between age group of 5-14 years by retrograde TEN fixation. Patients were mobilized without weight bearing on the 7th day post operatively. Partial weight bearing was started at 6 weeks and full weight bearing at 12 weeks depending on the fracture configuration, callus response and associated injuries. Follow up was done at 6 weeks, 12 weeks and 24 weeks. Results: Average radiological union was seen in 12.8 weeks. Maximum patients achieved full range of hip and knee movements. Only two had knee stiffness. Based on Flynn‘s criteria 70% excellent and 30% good results were recorded. Conclusion: Titanium Elastic Nailing system for the treatment of paediatric shaft femur fractures in the age group of 5-14 years is an effective method, as it avoids any growth disturbance by preserving the epiphyseal growth plate, and avoids bone damage or weakening through the elasticity of the construct.

Keyword :

Titanium Elastic Nail (TEN), Flynn criteria, Retrograde, Shaft femur, Children