Publication:

Outcome of closed intramedullary fixation of femoral shaft fracture by titanium elastic nail in children

Background Femoral shaft fractures are most common fractures in paediatric orthopaedic age group. The best treatment between six to fourteen years of age is a matter of debate. Titanium flexible elastic intramedullary nailing has become a well-accepted method of treatment of paediatric femoral shaft fractures. This study aims to evaluate the functional outcome of treatment of femoral shaft fracture by closed intramedullary titanium elastic nail (TEN) in children age between 6 to 14 years.

Methods This prospective observational study was conducted over a period of two years from July 2017 to June 2019. Thirty children (23 boys, 7 girls) aged 6-14 years with femoral diaphyseal fractures were stabilized with retrograde titanium elastic nail. The results were evaluated by using Flynn’s TEN scoring criteria. Two nails were used in each fracture.

Results Mean age was 11.1±1.8 years with male female ratio 3.3:1. Male patients were predominant in this study. Type of fracture were observed that 10(33.3%) cases were oblique, 18 (60.0%) cases were transverse and spiral 2 (6.7%). Radiological union in all cases were achieved in a mean time of 9.6±1.9 weeks. Objective evaluation showed that 21 (70.0%) patients had knee flexion >130°, 7 (23.3%) had restricted motion of 120–130°, and 2 (6.7%) had a range of 100–120°. The results were excellent in 23 patients (76.7%), satisfactory in 7 patients (23.3%) and there was no poor result.

Conclusions TEN fixation of paediatric femoral shaft fractures is an excellent method of treatment in children aged 6-14 years.