ABSTRACT
Childhood injuries have become a global public health concern. It is estimated that 10-25 % of paediatric injuries are fractures. The definitive treatment of paediatric diaphyseal fractures has always remained controversial and determined by surgical experience and local trends of practice. The aim of this study was to study the outcome of surgically managed diaphyseal fractures in children.METHODSA prospective interventional study was done comprising of 42 fractures in 28 children having displaced diaphyseal fractures of major long bones. Flynn’s scoring criteria was used to study the outcome.RESULTSThe observations of this study are based on 42 surgically managed diaphyseal fractures in long bones in 28 children. The mean age of patients was 10.85 years. The commonest mode of injury was fall while playing (from level ground) (18 cases, 4.29%). The commonest bones to get fractured were both radius and ulna together (50%), followed by femur (25%), tibia (21.43%) and ulna singly (3.57%). The commonest location of fracture was middle third shaft (25 fractures, 59.52%). Transverse fractures accounted for major proportion of this series. Among the 42 fractures, 39 fractures were treated with titanium elastic nailing and 2 compound fractures were treated with debridement and external fixator application. One 15 year old girl was treated by femur interlock nailing. Among the 25 children who could be followed up, the average follow up period was 22.08 weeks. The mean period of union was 10.69 weeks. Majority of the fractures had excellent outcome (30 fractures, 76.92%), 7 fractures (17.95%) had satisfactory outcome while only 2 fractures (5.13%) had poor outcome.CONCLUSIONSTitanium elastic nailing (TENS) is found to be an effective method of treating closed displaced diaphyseal fractures in children. It is better than plaster cast immobilization due to shorter period required for union, better fracture reduction and stabilization besides prevention of stiffness of adjacent joints and fracture disease. More use of this method is recommended due to these advantages