Objective： Fractures of the femur are the most incapacitating fractures. For children aged 6-14 years, there is no clear consensus as to the preferred treatment. The conventional treatment of traction and cast- ing i...Objective： Fractures of the femur are the most incapacitating fractures. For children aged 6-14 years, there is no clear consensus as to the preferred treatment. The conventional treatment of traction and cast- ing is no longer recommended. We report our experience in titanium elastic nailing for treatment of paediatric femoral diaphyseal fractures. Methods： Thirty patients in the age group of 6-16 years with displaced diaphyseal femoral fractures were sta- bilized with titanium elastic nails. Patients were followed up clinically and radiologically for a minimum period of 1 year. The final results were evaluated using Flynn＇s criteria. Tech- nical difficulties and complications associated with the pro- cedure were also analysed. Results： Overall results were excellent in 20 cases and satisfactory in 10 cases. No patient had poor result. The average hospital stay was 9 days. All the fractures healed with an average time to union of 6.86 weeks. The most com- mon complication encountered was soft tissue irritation at the nail entry site seen in 6 cases. Clinically, lengthening was noticed in 4 cases, while no patient had shortening. Malalignment was seen in only 6 cases. Perioperative diffi- culties encountered were failure of closed reduction seen in 6 cases and corkscrewing of nails in one case. Conclusion： Titanium elastic nails are a relatively easy to use, minimally invasive, physeal-protective implant sys- tem with high rate of good and excellent outcomes in chil- dren aged 6-16 years. Technical pitfalls can be eliminated by adhering to the basic principles.展开更多
文摘Objective： Fractures of the femur are the most incapacitating fractures. For children aged 6-14 years, there is no clear consensus as to the preferred treatment. The conventional treatment of traction and cast- ing is no longer recommended. We report our experience in titanium elastic nailing for treatment of paediatric femoral diaphyseal fractures. Methods： Thirty patients in the age group of 6-16 years with displaced diaphyseal femoral fractures were sta- bilized with titanium elastic nails. Patients were followed up clinically and radiologically for a minimum period of 1 year. The final results were evaluated using Flynn＇s criteria. Tech- nical difficulties and complications associated with the pro- cedure were also analysed. Results： Overall results were excellent in 20 cases and satisfactory in 10 cases. No patient had poor result. The average hospital stay was 9 days. All the fractures healed with an average time to union of 6.86 weeks. The most com- mon complication encountered was soft tissue irritation at the nail entry site seen in 6 cases. Clinically, lengthening was noticed in 4 cases, while no patient had shortening. Malalignment was seen in only 6 cases. Perioperative diffi- culties encountered were failure of closed reduction seen in 6 cases and corkscrewing of nails in one case. Conclusion： Titanium elastic nails are a relatively easy to use, minimally invasive, physeal-protective implant sys- tem with high rate of good and excellent outcomes in chil- dren aged 6-16 years. Technical pitfalls can be eliminated by adhering to the basic principles.
