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Comparative Study Using Intramedullary K-wire Fixation Over Titanium Elastic Nail in Paediatric Shaft Femur Fractures
Sanjiv Kumar1, Tushar Anand2, Sudhir Singh3
1Assistant Professor, Department of Orthopaedics, Era,s Lucknow Medical College & Hospital , Lucknow, UP, India .
Insights
Titanium elastic nails and K-wires offer similar outcomes for pediatric femur fractures, but K-wires are a more cost-effective option. This study compared fixation methods for pediatric femoral shaft fractures.
Area of Science:
- Pediatric Orthopedics
- Trauma Surgery
- Biomaterials in Medicine
Background:
- Femoral shaft fractures are common in children, often requiring prolonged immobilization with conservative treatments.
- Flexible intramedullary implants facilitate early rehabilitation for pediatric diaphyseal femur fractures.
Purpose of the Study:
- To compare the efficacy and outcomes of titanium elastic nail (TENS) versus intramedullary K-wire fixation for pediatric diaphyseal femur fractures.
Main Methods:
- A prospective randomized study involving 52 children (6-14 years) with femoral shaft fractures.
- Fractures were treated with either closed percutaneous K-wire fixation (Group I) or closed percutaneous TENS fixation (Group II).
- Partial weight-bearing was initiated at 6 weeks post-surgery, with full weight-bearing upon clinico-radiological union.
Main Results:
- Both K-wires and TENS showed an average radiological union time of 6-10 weeks.
- Complications included entry site irritation (2 cases each group), unacceptable mal-alignment (1 case each group), and limb-length discrepancy (few cases, except 2 TENS cases).
- No statistically significant difference in outcomes was observed between the groups, but K-wire fixation was significantly more cost-effective.
Conclusions:
- K-wires provide a cost-effective alternative for treating pediatric femoral shaft fractures, potentially benefiting patients from lower socioeconomic backgrounds.
- Addressing the high cost of treatment can reduce neglect of these common pediatric fractures.
Background:
Fracture shaft femur is common paediatric trauma leading to significant morbidity. Conservative treatments available are associated with prolonged periods of immobilization. Use of flexible intramedullary implant allows early rehabilitation in diaphyseal fractures of femur in children.
Aim:
The aim of the present study is to compare fixation of diaphyseal femur fracture by titanium elastic nail and intramedullary K-wires in children.
Setting And Design:
Prospective randomized study in a tertiary care hospital.
Material And Methods:
Fifty-two children between 6 years and 14 years of age with femoral shaft fracture were assigned either in Group I or Group II based on computer generated random numbers. In Group I closed percutaneous intramedullary K- wire fixation and in Group II closed percutaneous intramedullary titanium elastic nail was used to fix the fractures. Partial weight bearing was allowed after 6 weeks of surgery and full weight bearing at clinico-radiological union.
Results:
Average time of radiological union was 6 to 10 weeks in both groups. In both the groups two cases had entry site irritation which resolved with early implant removal. One case in both the groups had unacceptable mal-alignment. Both the groups had few cases of limb-length discrepancy, which was in acceptable limit, except two cases of TENS. There was no statistically significant difference between the results of both the groups. But, using K-wires significantly reduced the cost of treatment.
Conclusion:
Most of such fractures in our society are neglected because of high cost of treatment. Providing a cheaper alternative in form of K-wires may be beneficial for the patients from low socio-economic status.
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