Experience with Titanium Elastic Nails (TENS) for Femur Fracture and its Complications among 5-15 Years Age Group in Odisha: A Prospective Study

Abstract

Introduction: Paediatric femur fracture management is still a controversial issue, because of the natural healing power of this age group. One school of thought endorses conservative management i.e., hip spica cast and other group of orthopaedic surgeons with advent of newer surgical techniques prefer surgical management of this fracture. Aim: To analyse the results of paediatric femur fracture treated with Titanium Elastic Nails (TENS) among 5-15 years age group in Odisha. Materials and Methods: This was a prospective observational study of 25 cases of paediatric femur fracture treated with TENS in Department of Orthopaedic, Sriram Chandra Bhanja Medical College and Hospital (SCBMCH), from July 2017 to December 2019 and functional results were analysed with Flynn TEN scoring criteria. Radiological assessment was done by Anthony scale for grading of callus formation. Results: Excellent results were achieved in 19 (76%), satisfactory in 4 (16%) and poor in 2(8%) cases as per Flynn criteria. Average time for full weight bearing was after the fracture union which was evident in radiology with a mean of 7.9 weeks (range 6-12 weeks). The common complications were pain around knee 6(24%), limb length discrepancy 6(24%) followed by bursa at tip of nail in 5 (20%) that subsided after nail removal. Conclusion: TENS is an effective modality of surgical method for paediatric femoral shaft fracture with precise technique and proper after care.

Keywords

• flynn criteria
• functional outcome
• paediatric femur fracture