Treatment of Diaphyseal Fractures of the Femur in Paediatric Age Group: A Comparative Study of Locking Compression Plate Versus Titanium Elastic Nailing System (TENS)

Venkataraman, Sagar; Ethiraj, Prabhu; Shanthappa, Arun H; Vellingiri, Kishore

doi:10.7759/cureus.28924

Cited by 2 publications

(1 citation statement)

References 17 publications

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“…Of these, 340 articles were left for full-text review, and 21 articles were excluded according to the inclusion and exclusion criteria. Finally, 4 RCT studies [ 8 – 11 ], 5 retrospective studies [ 12 – 16 ], and 1 prospective study [ 17 ] were included in the review. The literature screening process (PRISMA diagram) is shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

Elastic Stable Intramedullary Nailing Versus Plate Internal Fixation for Pediatric Diaphyseal Femur Fractures: A Systematic Review and Meta-analysis

Liu,

Li,

Bai

et al. 2024

JOIO

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Background Elastic stable intramedullary nailing (ESIN) and plates are currently the main internal fixation for treating Pediatric Diaphyseal Femur Fractures (PDFF), and the optimal choice of internal fixation is controversial. The purpose of this meta-analysis is to compare the surgical outcomes and complications of the two fixation methods. Materials and Methods MEDLINE, Embase, and the Cochrane Library were systematically searched for studies published up to March, 2023, that compared ESIN and plate fixation techniques for treating PDFF. Pooled analysis identified differences in surgical outcomes between ESIN and plate, mainly regarding surgical outcomes and postoperative complications, such as time at surgery, fracture healing time, blood loss and related complications. Results We included 10 studies with 775 patients with PDFF in our review. Of these, 428 and 347 were treated with ESIN and Plate, respectively. In terms of postoperative complications, ESIN led to a shorter surgery time [MD = − 28.93, 95% CI (− 52.88 to − 4.98), P < 0.05], less blood loss [MD = − 66.94, 95% CI (− 87.79 to − 46.10), P < 0.001] and more fracture healing time [MD = 2.65, 95% CI (1.22–4.07), P < 0.001]. In terms of postoperative complications, ESIN led to fewer fections (RR = 0.77, 95% CI 0.37, 1.60, P = 0.48), fewer angulation deformities (RR = 0.80, 95% CI 0.35, 1.83, P = 0.60) and more prominent implants (RR = 3.36, 95% CI 1.88, 6.01, P < 0.001), more delayed unions (RR = 4.06, 95% CI 0.71, 23.06, P = 0.11). Conclusions ESIN and Plate have similar rates of complications besides a prominent implant rate, while ESIN has a shorter period of operation and less intraoperative bleeding. Although both options are suitable, the results of this study support the use of ESIN rather than plates in the treatment of PDFF in terms of complication rates. In clinical applications, surgeons should choose the appropriate treatment method according to the actual situation.

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Section: Resultsmentioning

confidence: 99%

Elastic Stable Intramedullary Nailing Versus Plate Internal Fixation for Pediatric Diaphyseal Femur Fractures: A Systematic Review and Meta-analysis

Liu,

Li,

Bai

et al. 2024

JOIO

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The Outcome of Pediatric Femur Fractures Fixation with Titanium Elastic Nail System

Acharya

2023

NOAJ

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Introduction: Pediatric femur fractures are commonly present because of high-velocity injuries in children. It is the most common reason for pediatric hospital admission due to trauma. There is a spectrum of choices for fixation for these fractures, but the best method has always been debated. In this study, we share our experience of fixation of pediatric diaphyseal femur fractures at our center using Titanium Elastic Nail System. Method: A hospital-based prospective study was conducted between January 2019 to June 2022. Patients aged between 5 to 12 years with shaft of femur fracture and body weight of less than 49 kg were included in the study. Children with pathological fractures, ipsilateral limb injuries, metabolic bone disease, and neuromuscular disorders were excluded. All patients were followed up till nine months with radiographic and clinical assessment. Result: A total of 47 children were included in this study. The mean age was 8.08±2.17 years, and the mean weight was 26.55±6.46 kg. Postoperatively the mean union time was 11.36 weeks, whereas the mean time for full weight bearing was 9.70 weeks. Two (4.25 %) patients had transient superficial wound infection. Four (8.51%) patients had skin irritation due to nail tips, and five (10.63%) patients had more than 1cm of limb length discrepancy. Limb malalignment >10 degrees was noted in two (4.25%). At the end of nine months, 70.21% reported excellent, 25.53% satisfactory, and 4.25% poor outcomes as per Flynn’s criteria. Conclusion: Titanium Elastic Nailing System is a minimally invasive pediatric femur fracture fixation method with relatively few associated complications and predictable favorable outcomes. Keywords: Diaphyseal, Pediatric femur fracture, Titanium Elastic Nailing System

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Treatment of Diaphyseal Fractures of the Femur in Paediatric Age Group: A Comparative Study of Locking Compression Plate Versus Titanium Elastic Nailing System (TENS)

Cited by 2 publications

References 17 publications

Elastic Stable Intramedullary Nailing Versus Plate Internal Fixation for Pediatric Diaphyseal Femur Fractures: A Systematic Review and Meta-analysis

Elastic Stable Intramedullary Nailing Versus Plate Internal Fixation for Pediatric Diaphyseal Femur Fractures: A Systematic Review and Meta-analysis

The Outcome of Pediatric Femur Fractures Fixation with Titanium Elastic Nail System

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