Role of titanium elastic nailing in pediatric femoral shaft fractures

Abstract

Background: Titanium elastic nailing has emerged as a treatment of choice for stabilization of paediatric diaphyseal femoral fractures. Materials and Methods: Between 2007 and 2012, we treated 18 fractures of the femur using closed titanium elastic nailing (TEN),in pediatric patients. This study was done as a retrospective study on 18 cases of fracture of the femoral diaphysis, operated between 2007 and 2010. An assessment of the available postoperative radiographs revealed 88.8% (16 of 18) of the fractures had nails, which formed a divergent C configuration; cortical contact by both nails was visible in 77.7% (14 of 18) and the nails crossed above and below the fracture site in 83.3% (15 of 18). Results: The final outcome was adjudged as excellent when there was anatomical or near anatomical alignment with no postoperative problems in 61.1% (11 of 18) of the patients, satisfactory when there was acceptable alignment and leg length, with resolution of postoperative problems in 22.2% (4 of 18) of the cases, and poor in the presence of unacceptable alignment or leg length, with unresolved postoperative problems in 16.6% (3 of 18) of the cases. Minor or major complications occurred in seven patients. Poor outcomes were due to limb length discrepancy> 2 cm in one1 patient (5.5%), rotational deformity in one patient (5.5%), and varus malunion in one patient (5.5%). Conclusion: We recommend TEN in pediatric patients.

Keywords

• femoral diaphyseal fractures
• pediatric
• titanium elastic nailing