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Titanium Elastic Nailing System (TENS) for Tibia Fractures in Children: Functional Outcomes and Complications
K M Kc1, P Acharya1, A Sigdel1
1Department of Orthopedics, Civil Service Hospital, Minbhawan, Kathmandu, Nepal.
Insights
Titanium elastic nails offer an effective surgical option for pediatric tibial fractures, providing quicker recovery and good alignment. While complications can occur, they are generally manageable with careful precautions.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Traumatology
Background:
- Closed reduction and casting remain a primary treatment for pediatric tibial fractures.
- Surgical management is increasingly favored for faster recovery and reduced complications.
- Flexible intramedullary nails offer advantages in alignment, rotation, and patient recovery.
Purpose of the Study:
- To evaluate the efficacy and outcomes of using titanium elastic nails for pediatric tibial fractures.
- To assess complications associated with titanium elastic nail fixation in pediatric tibial fractures.
Main Methods:
- Retrospective study analyzing pediatric tibial fractures treated with two titanium elastic nails.
- Evaluation of fracture alignment, union time, infection, and limb length discrepancy.
- Assessment of joint mobility and complications such as malunion and delayed union.
Main Results:
- 45 patients (62.2% male, 37.8% female) with an average age of 9.48 years were studied.
- Average fracture healing time was 11.17 weeks.
- Complications included malunion (4.4%), delayed union (8.8%), limb length discrepancy (6.6%), nail prominence/irritation (13.6%), and superficial infection (4.4%).
Conclusions:
- Titanium elastic nail (TENS) fixation is a reliable and effective method for pediatric tibial fractures requiring surgery.
- Potential complications are manageable and avoidable with proper precautions.
- TENS provides a simple, rapid, and effective surgical solution for pediatric tibial fractures.
Introduction:
Closed reduction and cast application is still regarded as first line treatment for pediatric tibial fractures. Over the past few decades, management of pediatric tibial fractures has shifted more towards operative intervention because of quicker recovery, shorter rehabilitation period, less immobilization, lack of stiffness of adjoining joints, and less psychological impact to the children. Flexible intramedullary nails not only fulfill the above advantage but also maintain alignment and rotation.
Methods:
This was a retrospective study of pediatric tibial fractures fixed with two titanium elastic nails through proximal ends of bones. Alignment of fracture, any infection, delayed union, non union, limb length discrepancy, motion of knee joint, and fracture union time were measured during follow-up examination.
Results:
Forty-five patients were enrolled into the study out of which 28 (62.2%) were male and 17 (37.8%) were female. Average age of patient was 9.48±2.17 years and average time taken to heal the fractures (both clinical and radiological) was 11.17±2.81 weeks. There were 2 (4.4%) of malunion, 4 (8.8%) of delayed union, 3 (6.6%) of limb shortening, 2 (4.4%) of limb lengthening, 6 (13.6%) of nail prominence and skin irritation, 2 (4.4%) of superficial infection at nail entry site and one case of re-fracture.
Conclusions:
Titanium elastic nail fixation is a simple, easy, rapid, reliable and effective method for management of pediatric tibial fractures in patients with operative indications. There may be the chances of complication following the TENS in tibia but these are avoidable as well as manageable with careful precautions.
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