Flexible Intramedullary Nails for Fixation of Adolescent Diaphyseal Tibial Shaft Fractures

Abstract

Background: Diaphyseal tibial shaft fractures are the second most common fracture in hospitalized children resulting from both high and low energy trauma. Operative treatment requires implants that do not violate open physes and have less complications rate than traditional treatment methods. Flexible intramedullary nails had gained popularity for treatment of paediatric diaphyseal tibial shaft fractures. Patients and Methods: 45 patients with diaphyseal tibial fracture were treated by flexible intramedullary nails. There were 30 male and 15 females. The youngest patient in our study was 10 years old while the oldest was 18 years old. Functional and radiological evaluations were done for all patients at the last follow up. Results: Most common mechanism of injury was road traffic accident followed by falling from height. 62.2 % of the cases had simple fracture (28 patient) while 26.7% of cases (12 patients) had type I open fractures and 11.1 % of the cases (5 patients) had type II open fractures. All fractures achieved full fracture union at a mean of 12 week with range from 10 to 18 week. Two cases suffered from nonunion that treated later on by bone grafting. One patient had postoperative fracture angulation. Conclusion: Flexible intramedullary nails can be used safely in adolescents with satisfactory results. It provides acceptable fracture redction and rapid healing with an acceptable rate of complications and return to unrestricted physical activity.