Study of enders nailing in tibia shaft fracture in paediatric patient

Abstract

Background and Aim:The exposed anatomical location of the tibia makes it vulnerable to the direct blow and high energy trauma as a result of motor vehicle accidents, thus resulting in comminuted fractures which are frequently open with significant loss of skin and soft tissues. The purpose of our study was to present results of fixation of unstable tibial shaft fractures in children with Ender's nailing. Material and Methods: This is a study of 30 patients of unstable tibial shaft fractures in children treated with Ender's nailing. 24 were closed fractures & 6 were open grade one fractures with only punctured wounds. Twenty patients had concomitant fibula fractures. In 26 patients tibia fracture was an isolated injury, one had associated same side clavicle fracture and one had associated same side lower end radius fracture. Results: Average time for fracture union was 9 weeks (range 6 to 15 weeks). All fractures united without 2nd operative intervention. Slight nail back out occurred in many patients, but only in 2 patients significant proximal migration of nails occurred causing some knee irritation, but not requiring any operative intervention before fracture union. In all patients implant removed 6 to 7 months after surgery. There was some restriction of knee movements in 4 patients in which nails were significantly backed out, but after implant removal full knee movements achieved in all patients there was full ankle movements in all patients at final follow-up. Conclusion:Based on our results, Ender's nailing is an effective method of treatment in these cases, which allows rapid healing of tibial shaft fractures with an acceptable rate of complications.