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How safe is titanium elastic nail application in the surgical treatment of tibia fractures in children?
Insights
Titanium elastic nails (TEN) offer a safe and effective solution for pediatric tibia fractures when conservative treatment fails or is not feasible. This method demonstrated excellent outcomes with no observed complications in a retrospective study.
Area of Science:
- Pediatric Orthopedics
- Trauma Surgery
- Biomaterials and Implants
Background:
- Conservative management is standard for pediatric tibia fractures.
- Certain cases necessitate alternative fixation methods due to failure or inapplicability of conservative approaches.
Purpose of the Study:
- To assess the efficacy and safety of Titanium Elastic Nails (TEN) for pediatric tibia fractures.
- To evaluate TEN fixation in cases where conservative measures were unsuccessful or not indicated.
Main Methods:
- Retrospective analysis of 30 pediatric patients treated with TEN between 2007-2011.
- Inclusion criteria: poly-trauma, open fractures, reduction loss, or failed closed reduction.
- Outcomes assessed using Flynn criteria with a mean follow-up of 18 months.
Main Results:
- Mean union time was 8 weeks for closed and 14 weeks for open fractures.
- Excellent or good results achieved in all 30 cases (23 excellent, 7 good) per Flynn criteria.
- No instances of epiphyseal damage, rotational deformity, infection, implant failure, or re-fracture were reported.
Conclusions:
- Titanium Elastic Nails (TEN) provide an easy, effective, and safe fixation for pediatric tibia fractures.
- TEN is suitable for complex cases including open fractures, irreducible fractures, loss of reduction, and associated trauma.
- This study supports TEN as a reliable option for challenging pediatric tibia fracture management.
Abstract:
Tibia fractures in children are generally treated successfully by conservative means. The aim of this study was to evaluate the efficacy and safety of fixation using Titanium elastic nails (TEN) in pediatric tibia fractures in which conservative measures failed or were deemed inapplicable. In this study, 30 patients who had tibia fractures and were fixated with TEN between 2007 and 2011 were analyzed retrospectively. The procedure was performed after poly-trauma in six patients, open fracture in seven, reduction loss in twelve, and unsuccessful closed reduction in five patients. The number of girls and boys was 3 and 27, respectively, with a mean age of 9.8 years. The evaluation criteria of Flynn et al. were used in the analysis of the results. The mean follow-up period was 18 months. The mean period of union was 8 weeks and 14 weeks in closed and open fractures, respectively. Epiphyseal damage, rotational deformity, need for reintervention, deep infection, implant failure, or recurrent fracture was not observed in any case. According to the Flynn evaluation system, 23 cases were evaluated as excellent, and 7 as good. Fixation with TEN is an easy, effective, and safe method that can be used in tibia fractures that are open, irreducible, or with loss of reduction and in cases with accompanying trauma, such as floating knee.
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