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Orthopedic Robot-Assisted Femoral Neck System in the Treatment of Femoral Neck Fracture
Published on: March 3, 2023
TREATMENT OF FEMORAL SHAFT FRACTURES IN CHILDREN OF PRESCHOOL AGE
G Bajelidze1, M Vardzukashvili1, M Bajelidze1
1David Tvildiani Medical University, Tbilisi, Georgia.
Insights
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.
Abstract:
There are several methods of treatment of femoral shaft fractures in small age children (from 2 to 5 yaers of age). Aim of our study was to compare two of them: skeletal traction followed by spica cast and osteosynthesis by Titanium elastic intramedullary nails. We analyzed and compared 93 patient's data from which 44 patients were treated by skeletal traction followed by Spica cast ("traction group") and 49 patients were treated by osteosynthesis with titanium elastic nails ("TEN's group"). According to Flynn's scoring criteria for TEN there was not statistically significant difference between groups: in "traction group" 33 patient had excellent results, 8 patient - satisfactory and 3 patient - poor results; in "TEN's group 42 patient had excellent results, 6 patient - satisfactory and 1 patient - poor result. There was statistically significant difference between groups according the beginning partial weight bearing for patient after treatment - 4,67 weeks for "TEN's group" and 5,68 for the "traction group". We created questionnaire for parents and caregivers about difficulties of patients' care at home before they start to walk and there was also significant difference which showed that care for patient in "TEN's group wasn't as difficult as for patients in "traction group". There was no case of infection, delayed union or nonunion in all of the 93 patients. We concluded that osteosynthesis by titanium elastic intramedullary nail remains excellent choice of treatment for this pathology and it can be successfully used as alternative for conservative treatment in this age of patient's.
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