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Paediatric Long Bone Fractures Managed with Elastic Intramedullary Nails: A Retrospective Study of 30 Patients
Susanta Khuntia1, Shakti Swaroop1, Bishnu P Patro1
1Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, IND.
Insights
Titanium elastic nails (TEN) offer a safe, minimally invasive option for pediatric long bone fractures, achieving successful union in 30 cases. While minor complications occurred, TEN provides stable reduction and good outcomes for children.
Area of Science:
- Pediatric Orthopedics
- Surgical Innovation
- Biomaterials in Medicine
Background:
- Pediatric long bone fractures require effective treatment methods.
- Titanium elastic nails (TEN) present an alternative to traditional casting.
- TEN are often preferred for children over six years old.
Purpose of the Study:
- To evaluate the efficacy and safety of titanium elastic nailing (TEN) for pediatric long bone fractures.
- To assess union rates, complications, and functional outcomes in children treated with TEN.
- To determine the suitability of TEN as a minimally invasive technique.
Main Methods:
- Retrospective case series of 30 pediatric patients with long bone fractures managed with TEN.
- Data collection included patient age, fracture type, follow-up duration, union time, and complications.
- Analysis of outcomes such as infection, limb length discrepancy, and hardware prominence.
Main Results:
- Successful fracture union was achieved in all 30 cases, with a mean union time of 10 weeks.
- Superficial infections in three cases resolved with antibiotics and debridement.
- Minor limb length discrepancy in three femur fractures was functionally insignificant but requires monitoring.
Conclusions:
- Titanium elastic nailing (TEN) is a safe and effective minimally invasive technique for pediatric long bone fractures.
- TEN provides stable reduction, particularly for long spiral fractures, leading to successful union.
- Further long-term comparative studies with casting are needed to fully establish TEN's role.
Abstract:
Elastic intramedullary nailing or titanium elastic nail (TEN) is an alternative method for the treatment of various pediatric long bone fractures. Titanium nails are preferred over plaster cast and stainless steel nails for children older than six years. Our series included 30 paediatric long bone fractures who were managed with TEN. The mean age was 9.3 years and the mean follow-up period was 28 months. A mean time of 10 weeks was recorded for the union of all fractures. The occurrence of superficial infection in three cases healed with antibiotics and minor debridement. Limb length discrepancy was seen in three cases of femur fracture, which was functionally insignificant, but it may be a potential problem needing close follow-up until skeletal maturity is attained. An elastic intramedullary nail or TEN in long bone fractures in children is a safe and minimally invasive technique that achieves stable reduction, especially in long spiral fractures till union. We attained successful union and good results in all our 30 cases with long bone fractures in children. A few complications of hardware prominence were resolved with implant removal. Long-term studies with a comparison to casting techniques in paediatric long bone fractures are required.
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