Tuesday, September 12, 2017

Evaluation of Results of Intramedullary Fixation of Paediatric Fracture Shaft Femur by Titanium Elastic Nail

 Deepak Srivastav1*, Mithlesh Kumar2, Arpita Mohan3
1Assistant Professor, Department of Orthopaedics, Hind Institute of Medical Sciences, Lucknow, India
2Assistant Professor, Department of Orthopaedics, Government Medical College, Azamgarh, India
3Assistant Professor, Department of Dentistry, Hind Institute of Medical Sciences, Lucknow, India

*Address for Correspondence: Dr. Deepak Srivastav, Asst. Professor, Department of Orthopaedics, Hind Institute of Medical Sciences, Lucknow, India

ABSTRACT- Background: Femoral shaft fractures are most common fractures in paediatric orthopaedic age group. There are distinct methodologies to treat them. Elastic stable intramedullary nailing is one in every of them and a longtime and reliable methodology for treating these fractures.
Aims: To evaluate the clinical, functional and radiological outcome of intramedullary fixation of displaced fracture shaft femur in skeletally immature children using titanium elastic intramedullary nails.
Material and Methods: 65 Femoral shaft fracture in 60 children aged 6-14 years were fixed with titanium intramedullary elastic nail under image intensifier control between July 2013 and June 2017.Two nails of proper and equal diameter were used for fracture fixation. No external splint was used after surgery. Outcomes assessed on the basis of Flynn et al scoring criterion.
Results: All patients achieved complete healing at a mean of 9.5 weeks. 51 fracture reduced by closed means but 14 needs open reduction. Common size of elastic nail used was 3mm. no major complication was recorded all were minor and can be taken care off. Most common was entry site skin irritation recorded in 10 patients. 90% had excellent result and 10% had satisfactory.
Conclusion: Elastic stable intramedullary nailing is the method of choice for the Femoral shaft fracture in paediatric patients, because it is minimally invasive and provide six point fixation and shows very good functional and cosmetic result. It allows early ambulation and shorter hospital stay and higher parent satisfaction. ESIN also provide flexural, translational and rotational stability as well.
Key-words- Elastic stable intramedullary nailing (ESIN), Titanium elastic nail (TEN), Femoral shaft fracture, Paediatric