Surgical Management of Long Bone Fracture of Lower Limb in Pediatric by Titanium Elastic Nails.

ABSTRACT

Background: Skeletal trauma accounts for 10-15% of all childhood injuries. The increasing incidence of fractures in children mainly attributed to increased road traffi c accidents and sports participation. Materials and Methods: The study was conducted from October 2012 to April 2015 at Terna Medical College, Navi Mumbai. A 28 pediatric patients (20 male and 8 female), who came to emergency department with long bone fractures subsequently, underwent surgical fi xation of long bones by titanium elastic nailing (TENS) were included in this prospective study. Results: Road traffi c accident was the main mode of injuries. The most common long bone fracture was femur 40% and 60% tibia fracture. Pattern of fracture 33.3% transverse, 13.3% commiunited, 20% oblique, 26.7% spira, 6.7% segmental. The level of fracture 80% middle third. The time interval between trauma and surgery was average 3.65 days. Average duration in 50.20 min. Average duration of immobilization is 7.2 weeks. Duration of stay in hospital was 10.25 days. Time of union is 10.35 weeks. Time of weight bearing in the present study is 11.8 weeks. Follow-up done for period of 24 weeks. According to Flynn’s criteria, 89% of patients were excellent and 11% satisfi ed; no patients reported their outcome as not satisfi ed. Conclusion: TENS is the method of choice for the management of long bone fractures in children, because its elastic mobility promoting rapid union at fractures site, stability ideal for early mobilization. It gives lower complication rate, good outcome. It allows an early functional and cast-free follow-up, quick pain reduction compared plating technique including a minimally invasive technique. A less time-consuming procedure and easier metal work removal, cosmetically a small scar. Our study results provide new evidence that expands the inclusion criteria for this treatment and shows that TENS can be successfully used regardless of fracture location and fracture pattern.