Can Titanium Elastic Nails be the First Treatment Choice in Pediatric Femoral Shaft Fractures?

Abstract

INTRODUCTION: To evaluate the clinical and radiological outcomes of school-age pediatric patients who underwent titanium elastic nailing (TEN) for femoral shaft fracture. METHODS: The medical charts of 61 children aged 4–12 years who underwent titanium elastic nailing (TEN) in our clinic for diaphyseal femoral fracture between 2015 and 2019 were evaluated retrospectively. Functional outcomes were evaluated according to the Flynn criteria. A total of 61 patients who met the inclusion criteria, with a mean age of 7.18 (4–12) years, were followed up for 37.60 (13–72) months. RESULTS: On evaluation of the clinical and radiological outcomes of patients, we observed satisfactory results in 93.4% of patients, with 72.1% (n = 44) achieving excellent and 21.3% (n = 13) achieving good outcomes. Complete union was observed radiologically in all patients except 1 for a mean period of 8.45 +- 2.56 (5–14) weeks. When the duration of hospital stay for non-orthopedic reasons was excluded, we found that patients were discharged from the hospital after a mean hospitalization period of 2.32 (1–7) days. Ten patients (16.4%) had pain due to skin irritation at the nail insertion site, 8 had malunion with an angulation of >5°, whereas only 1 had an angulation of >10°. DISCUSSION AND CONCLUSION: TEN is an easily applicable, minimally invasive, fixation technique resulting in less scarring. TEN should be the first treatment choice in children aged 4–12 years with diaphyseal femoral fracture as it provides early union, short hospitalization, and successful radiological and functional outcomes.

Keywords

• child
• titanium
• fracture fixation
• femoral fractures
• hospitalization