Comprehensive Study of Management of Diaphyseal Fractures of Long Bones in Children by Titanium Elastic Nailing System

Abstract

BACKGROUNDPaediatric fractures are usually treated conservatively with POP casts, as intramedullary nailing is contraindicated in growi ng bones and plating is associated with wound complications. These fractures heal satisfactorily with conservative treatment but may be associated with malunion and plaster complications sometimes. Titanium Elastic Nailing System (TENS) can be used in the internal fixation of paediatric fractures with satisfactory results and minimal complications. We wanted to study the functional outcome following the use of Titanium Elastic Nailing for the treatment of diaphyseal fractures of long bones in children. METHODS30 patients were treated with Titanium Elastic Nail System (TENS) for diaphyseal fractures of long bones who were admitted in Osmania General Hospital, Hyderabad during the study period-from October-2014 to October-2016. Patients were assessed clinically, radiologically and the complications were noted. RESULTSWe studied 17 (56.7%) femoral, 7 (23.3%) tibial fractures, 1 (3.3%) humeral and 5 (16.6%) forearm bone fractures. Average age of the patients is 10.93. In our study, the final outcome was excellent in 22 (73.33%) cases, satisfactory in 8 (26.67%) cases and there are no poor outcome cases.

Outcome of Surgically Managed Diaphyseal Fractures in Children- A Prospective Study

“…In the present study, there were 17 boys (60.71%) and 11 girls (39.29%). Similar preponderance of males was found in studies conducted by Ghilley SK et al 13 (64% boys and 36% girls), Baig MS et al 10 (73.3% boys and 26.7% girls), Tandon T et al 14 (54.8% boys and 45.2% girls), Babu A et al 15 (78.6 % were males and 21.3 % were females) and Arora R et al 12 (67% males, 33% females). Male preponderance in all these studies can be attributed to higher level of activity among male children as compared to female children.…”

“…Youngest child was 3 years old and eldest child was 15 years old. In the study by Baig MS et al, 10 majority of the patients (46.7%) were in the age group 9-12 years, followed by 13-16 years age group (33.3%), with the average age being 10.93 years. Kemal K et al 11 in their study comprising of children between 6-15 years, found the mean age to be 8.6 years.…”

“…In a study by Singh O et al, 16 59.40 % patients had history of fall, followed by road traffic accident (32%). Baig MS et al 10 and Babu A et al 15 found the predominant cause to be road traffic accidents. Many other studies also found road traffic accidents to be the predominant cause.…”

“…Cheng JC et al 17 and Tandon T et al 14 found the most common fracture site was distal radius. Baig MS et al 10 conducted a study on diaphyseal fractures in which the most common fractures were femoral fractures (56.7%). The varying values of bone involved in fracture could be because of difference in population, selection methods and rural/ urban setting.…”

An Outcome Analysis of Pediatric Diaphyseal Fractures Treated Surgically With the Titanium Elastic Nailing System

“…Furlan et al observed the average age of the patient as 11.7 years [ 10 ]. Baig et al observed the age group 13 to 16 years old ranked second (33.3%) [ 11 ]. Raut et al reported a distribution of patients in their study, revealing that the highest percentage, 36.7%, fell within the age range of six to eight years [ 12 ].…”