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TREATMENT OF FEMORAL SHAFT FRACTURES IN CHILDREN OF PRESCHOOL AGE
G Bajelidze1, M Vardzukashvili1, M Bajelidze1
1David Tvildiani Medical University, Tbilisi, Georgia.
Georgian Medical News
|May 19, 2019
Summary
Titanium elastic nails (TENs) offer a superior treatment for pediatric femoral shaft fractures compared to skeletal traction. TENs allow for earlier weight-bearing and easier home care, with comparable excellent outcomes.
Area of Science:
- Pediatric Orthopedics
- Traumatology
- Biomaterials Engineering
Background:
- Femoral shaft fractures are common in young children (2-5 years).
- Current treatments include skeletal traction with spica cast and surgical osteosynthesis.
- Titanium elastic nails (TENs) are an increasingly utilized surgical option.
Purpose of the Study:
- To compare the efficacy and patient care outcomes of skeletal traction versus TENs for pediatric femoral shaft fractures.
- To evaluate functional recovery and parental/caregiver burden associated with each treatment modality.
Main Methods:
- Retrospective analysis of 93 pediatric patients (2-5 years) with femoral shaft fractures.
- Patients were divided into two groups: skeletal traction with spica cast (n=44) and TENs (n=49).
- Outcomes assessed using Flynn's criteria, time to partial weight-bearing, and a custom parental/caregiver questionnaire.
Main Results:
- No statistically significant difference in excellent/satisfactory outcomes between groups based on Flynn's criteria.
- Significantly earlier partial weight-bearing in the TENs group (4.67 weeks) compared to the traction group (5.68 weeks).
- Parental/caregiver-reported home care was significantly less difficult for patients treated with TENs.
Conclusions:
- Osteosynthesis with titanium elastic intramedullary nails is an excellent and effective alternative treatment for pediatric femoral shaft fractures.
- TENs facilitate faster functional recovery and reduce the burden of home care for families.
- No infections, delayed unions, or nonunions were reported in either treatment group.
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