<p class="abstract"><strong>Background:</strong> A variety of methods have been described for the management of femur diaphyseal fractures in children between ages of 5 to 12 years. Some of the techniques include closed reduction and internal fixation (CRIF) with elastic nails, open reduction and internal fixation (ORIF) with compression plates, external fixators and skeletal traction with spica casting. This study was done to compare the outcome and complications of diaphyseal femur fractures in pediatric age treated with CRIF with Titanium elastic nails vs. ORIF with compression plates<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> The study was a prospective, clinical study. A total of 60 patients were studied. 30 patients were treated with CRIF with titanium nails and 30 patients were treated with ORIF with compression plates. Every patient operated was followed up at 3 weeks, 6 weeks, 3 months, 6 months and 3 monthly thereafter until implant removal.<strong></strong></p><p class="abstract"><strong>Results:</strong> Only 1 wound healing complication was noted in the TENS nail group which was skin irritation at the site of pin insertion. In the compression plating group, 6 patients developed wound complications, including superficial infections, deep infections and keloids. The range of movements at knee joint in the two groups was compared. Only 1 patient had a significant loss of flexion with ROM of less than 100 degrees in the TENS nail group. In the plating group 4 patients had a significant loss of flexion with ROM of less than 100 degrees. Limb length discrepancies were seen in 3 patients in the TENS nail group whereas the compression plating group showed 1 patient. 2 patients in the TENS group developed an angular deformity due to premature weight bearing. 3 patients in the compression plating group developed deformities at the fracture site. The average time for fracture union in the compression plate group was 10.7 weeks and was 14.7 weeks in the patients treated with TENS nail<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> No single fixation method can be considered superior in all types and patterns of pediatric diaphyseal femur fractures. Titanium elastic nails can be considered a better implant for treating pediatric femur fractures when compared to compression plates due to the lesser rates of surgical wound complications, better range of movements at knee joint and overall lesser complication rate as was recorded in this study<span lang="EN-IN">.</span></p>
Osteoid osteoma (OO) is a benign, solitary bone tumor of the long bones of the lower limbs and accounts for 10% to 12% of all benign bone. However, an OO of the femoral neck is extremely rare and difficult to treat. Arthroscopic excision of OO of the femoral neck has many advantages. We report a 15-year-old patient with OO of the femoral neck which was treated with arthroscopic excision. The clinical and radiographic findings along with the surgical management of the lesion are presented. The pain disappeared immediately after the operation. At the 14 months’ followup, the patient was pain free, and there was no evidence of recurrence.
Intracapsular femoral neck fractures are seen commonly in elderly people following a low energy trauma. 2-3% of all femoral neck fractures occurs in adults younger than 50 years and is often the result of highenergy trauma. Femoral neck fracture continues to be considered as an unsolved fracture in view of poor prognosis and variable outcome reported after different procedures. In developing countries the fracture often remains untreated as the patients do not seek treatment due to nonavailability of treatment facility or may be treated primarily by osteopaths or operated under suboptimal theatre conditions with poor quality implants. We prospectively studied the outcome of 54 patients managed with non vascularised fibular graft and cancellous screws between 2010-2015. ANOVA test was used as a test of significance and functional results were assessed by Modified Askin and Bryan criteria. To conclude, in patients younger than 60 years of age with neglected femoral neck fracture, non vascularised fibular graft acts as a reliable biological implant for revascularisation and gives excellent functional outcome.
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