Abstract: Background: Femoral shaft fractures account for 1.6% of all pediatric bony injuries. Angulation, malrotation and shortening are not always corrected effectively by conservative methods. These also depend on fracture anatomy; stable (transverse and oblique) and unstable (spiral and communited). Fixation of femur fractures in children & adolescents by flexible intra-medullary nailing is becoming widely accepted because of the lower chance of iatrogenic infection and prohibitive cost of in-hospital traction and Spica cast care. The objective of our prospective study was to compare stable and unstable diaphyseal fractures of femur in children aged between 5-15 years by using Titanium Elastic Nailing System. Subjective and objective study of clinical parameters like pain, comfort to the patients, early mobilization, operative technique, radiological evaluation for union, stages of weight bearing till complete recovery and any associated complications by using the above mentioned methods.
Methodology: Children and adolescents between the age group of 5-15 years with femoral shaft fractures who were admitted in Dr. B.R Ambedkar Medical College & Hospital meeting the inclusion criteria were selected. All patients underwent titanium elastic nailing for the femur fracture. Patients were followed up for a period of 6 months at 6, 12 and 24 weeks after surgery. 15 stable and 15 unstable fractures cases were studied.
Results: The outcome in stable fracture was good where as in unstable fractures there were 3 angular deformities and 1 case of limb length discrepancy.
Conclusion: Titanium elastic nails leads to rapid fracture union by preservation of fracture hematoma and limited soft tissue exposure. It also helps in preventing damage to the physis. A stable pediatric femoral diaphyseal fracture has very good results with minimal complications. Unstable pediatric femoral diaphyseal fractures though had good results in most cases but had angular deformities in 3 cases and 1 case developed limb shortening. According to our study it is better to use other operative techniques for severely unstable paediatric femoral diaphyseal fractures.
