Outcome of Titanium Elastic Nailing System in Diaphyseal Femoral Fractures of Children in the Age Group of 4-12 years

Eastern Medical College Journal Pub Date : 2024-03-28 DOI:10.3329/emcj.v9i1.71972

Mohammed Mahfoozur Rahman, Md Khaza Ahmed, Md Golam Sarwar, Mehedi Hasan, SM Tauhidur Rahman

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Abstract

Background: Femoral shaft fractures are the most common major pediatric injuries treated by orthopedic surgeons. Management of femoral diaphyseal fracture in the age group of 4-12 years is controversial. The purpose of this study is to demonstrate the effectiveness of intramedullary fixation of femoral shaft fractures by using Titanium Elastic Nailing System (TENS). Methodology: Twenty-six (26) children in the range of 4-12 years with recent (<3 days) femoral shaft fracture (24 closed, 02 Grade-I compound) were stabilized with Titanium Elastic Nail (TEN), between January 2019 and June 2022 in Eastern Medical College Hospital, Cumilla and Cumilla Trauma Centre. The diameter of the individual nail was selected as per Flynn’s formula and the results were evaluated by Flynn’s criteria. All patients were followed radiologically as well as clinically until fractures healed and for any complications. Results: Among the twenty-six (26) cases 18 were boys and 8 were girls. Twenty-three (23) cases were managed by closed reduction while three (3) cases required open reduction. The time duration of surgery ranged 20-45 minutes. The hospital stay ranged between 5 to 8 days (mean 6.5 days). The mean duration of follow-up was 21 months (range: 3 - 39 months). All fractures were radiologically united at 8-12 weeks (mean 10 weeks) and full weight bearing was possible in a meantime of 9.5 weeks. According to Flynn’s criteria, excellent results were found in 24 (92.3%) cases and satisfactory in 2 (7.7%) cases. Limb lengthening was noticed in 6 cases and rotational mal alignment was seen in 1 case. Conclusion: Intramedullary fixation with Titanium Elastic Nail may be the preferred method for the treatment of femoral fractures in children aged 4-12 years. As it is a safe, minimally invasive, surgeon-friendly technique and shows very good functional and cosmetic results. Eastern Med Coll J. July 2023; 8 (2): 1-6

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钛弹性钉系统对 4-12 岁儿童股骨骺骨折的治疗效果

背景：股骨干骨折是骨科医生治疗的最常见的主要儿科损伤。对于 4-12 岁年龄组的股骨干骺端骨折的处理存在争议。本研究旨在证明使用钛弹性钉系统（TENS）对股骨干骨折进行髓内固定的有效性。研究方法2019年1月至2022年6月期间，库米拉东部医学院附属医院和库米拉创伤中心对26名4-12岁股骨干骨折（24例闭合性骨折，02例I级复合性骨折）患儿进行了钛弹性钉（TEN）固定。根据弗林公式选择了单个钉子的直径，并按照弗林标准对结果进行了评估。对所有患者进行放射学和临床随访，直至骨折愈合和出现并发症。结果：在 26 例患者中，18 例为男孩，8 例为女孩。23例采用闭合复位，3例需要切开复位。手术时间为 20-45 分钟。住院时间为 5 至 8 天（平均 6.5 天）。平均随访时间为 21 个月（3 - 39 个月）。所有骨折均在 8-12 周（平均 10 周）后经放射科检查愈合，9.5 周后可完全负重。根据 Flynn 的标准，24 例（92.3%）疗效极佳，2 例（7.7%）疗效满意。6例患者的肢体被拉长，1例患者出现旋转错位。结论使用钛弹性钉进行髓内固定可能是治疗 4-12 岁儿童股骨骨折的首选方法。因为它是一种安全、微创、对外科医生友好的技术，并显示出非常好的功能和外观效果：1-6

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Eastern Medical College Journal

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