Study to assess the functional outcome of Intramedullary Titanium Elastic Nails in the Paediatric Lower Limb Long Bone Fractures

Abstract

Introduction: Femoral and tibial shaft fractures add up to less than 2% of all pediatric fractures, the preferred management has remained a real challenge to the orthopaedic fraternity. Upto the recent past conservative treatment was the method of choice for the treatment of shaft fractures in young adolescents and children. In order to avoid the effects of long immobilization, to decrease the loss of schooling and for finer post operative care, the operative approach has been popular for the last twenty years. Material and Methods: This study was conducted in department of orthopaedics, Rohilkhand medical college and hospital after seeking clearance from institutional ethical committee. The aim is to assess the functional outcome of intramedullary titanium elastic nails in paediatric lower limb long bones fractures. The patients attending the OPD and emergency department diagnosed with the fracture of femur and tibia was admitted for the study. This one year study was conducted from November 2018 to October 2019. A total of 30 children with diaphyseal fracture femur and tibia were enrolled in the study. When the patient arrives, a detailed history was gathered from the parents and/or attendants about age, sex, mode of injury and duration. Patients were assessed for associated injuries. Clinical and local examination was then performed following surgery. Results: The results were assessed as per criteria adopted by Flynn et al. Total of 20 patients had excellent outcome. There were no poor results. All the patients of the present series were able to squat and sit cross-legged at final follow up which was statistically significant. Conclusion: Titanium elastic nailing system technique, through the theory of two opposing balancing forces gives good firmness at the fracture site to allow early mobilization, it provides a biological environment that amplifies both quantity of callus formation and fracture healing.It may be considered to be a physiological method of treatment and it may prove to be the ideal implant to treat many paediatric femoral and tibial fractures. The technique is relatively simple, minimally invasive and healing occurs in extremely natural way with adequate mass of callus.