Titanium Elastic Nailing in Pediatric Femoral Shaft Fracture: A Study of 40 cases at NITOR, Bangladesh

ABSTRACT

Background: The Titanium Elastic Nail is mostly used in children to treat diaphyseal and metaphyseal fractures. The age of the patient, as well as the nature and location of the fracture, determine if the TEN is necessary. In some situations of femoral diaphyseal fractures, it is a successful and realistic therapeutic choice. The TEN allows for elastically stable intramedullary nailing. In terms of patient and parent happiness, as well as shorter confinement to bed and hospital stay, open reduction can produce a significantly better outcome than traction and spica cast or any other treatment. The aim of the study was to observe Titanium Elastic Nailing for treatment of femoral shaft fractures.Material & Methods:This observational study was conducted at the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Bangladesh. The study duration was 2 years and 8 months, from April 2019 to December 2021. The study was conducted with a total of 40 cases of femoral shaft fracture in pediatric patients who were admitted to the study hospital.Results:Male prevalence was observed in the present study, with 3.441 male female ratio. Mean±SD age of the participants was 8.8 ± 1.6 years, and sports injuries were the most common cause of fractures. 72.5% of the participants were aged between 5-10 years, and the age range of the participants was 5-13 years. 50% of the participants had fractures at the middle region of the femur, while 45% had fractures at the proximal region. Mean±SD hospital stay duration was 14.5 ± 2.4 days, with 62.58% having hospital stay between 7-14 days. Majority of the participants of the present study faced no complications, while 20% had <1.0 cm of leg length inequality, 2.5% had 1-2 cm leg length inequality, 2.5% faced infection, 5% faced entry site irritation and 1 patient had soft tissue irritation by prominent nail. At 12-monthg follow up, 75% had excellent outcomes while 20% had satisfactory outcomes.Conclusions:The titanium elastic nailing is an effective and viable treatment option in selected cases of femoral shaft fractures in the 5-13 years’ age group. Even if it is done by open reduction it gives much better result than traction & Spica cast or any other methods, in respect to patient & parent’s satisfaction & shorter confinement to bed & hospital stay.