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Titanium elastic nail fixation for paediatric femoral and tibial fractures
Gamal El-Adl1, Mohamed F Mostafa, Mohamed A Khalil
1Orthopaedic Department, Mansoura University Hospital, Mansoura Faculty of Medicine, Mansoura, Egypt. gkneladl@yahoo.com
Insights
Titanium elastic nails (TENs) provide effective treatment for paediatric femoral and tibial fractures. This study found excellent or satisfactory results in all patients, with minimal complications, allowing for early mobilization.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Biomaterials in Medicine
Background:
- Diaphyseal fractures of the femur and tibia are common in children.
- Titanium elastic nailing (TEN) is a surgical technique used for fracture fixation.
Purpose of the Study:
- To evaluate the treatment outcomes of pediatric femoral and/or tibial diaphyseal fractures using titanium elastic nails (TENs).
Main Methods:
- Prospective study following 66 pediatric patients with 48 femoral and 25 tibial fractures for 15-24 months.
- Utilized the Flynn et al. outcome rating system for final result evaluation.
- Data collected on operative time, hospital stay, immobilization, union time, and complications.
Main Results:
- Fracture union achieved in an average of 85 days, with 89% uniting within 3 months.
- Excellent (75.8%) and satisfactory (24.2%) results were reported based on the Flynn system.
- Minor complications included soft tissue/skin issues (9.1%) and limb-length discrepancy (9.1%).
Conclusions:
- Titanium elastic nailing (TEN) is a safe and effective method for treating pediatric diaphyseal fractures.
- TEN fixation allows for stable fixation, early mobilization, and shorter hospital stays.
- The technique yields excellent and satisfactory outcomes with a low rate of complications.
Abstract:
The aim of this prospective study was to evaluate the results of treatment of paediatric femoral and/or tibial diaphyseal fractures with titanium elastic nails (TENs). Sixty six patients with 48 femoral and 25 tibial fractures were followed-up for 15 to 24 months. The outcome rating system proposed by Flynn et al was used to evaluate the final results. Most patients (56.1%) were operated between 2 to 4 days after injury; a traction table was used in 54.8% of cases. The average operative time was 28 minutes, and the average hospital stay was 5.7 days. Postoperative immobilisation was used in 30% of cases, mostly with femoral fractures. The fractures united in an average time period of 85 days; 89% had united within 3 months. The nails were removed in 87.8% of cases after an average of 5.9 months. The following complications were noted: soft tissue and skin problem (9.1%) in relation to nail ends at the entry points, limb-length discrepancy (9.1%), malunion (4.5%). Based on Flynn et al's outcome rating system, 75.8% of the results were excellent, 24.2% were satisfactory and there were no poor results. With good knowledge of the technique of TEN fixation for paediatric femoral and tibial fractures, excellent and satisfactory results were achieved in all cases, with few minor complications. TENs can give stable fixation allowing early mobilisation and shorter hospitalisation with less disruption of patient and family life.
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