“Fracture of the shaft of the femur and tibia” is relatively frequent injury in children.
Majority of these fractures occur as a result of high velocity injury that leads to fracture of femur and / or tibia by tremendous force. The high velocity injury may be direct or indirect, such as that sustained in automobile accident or fall from height. Whatever the method of treatment, the goals should be to stabilize the fracture, to control length and alignment, to promote bone healing and to minimize the morbidity and complications for the child and his/her family. Recently in our institution, ender’s nail fixation for diaphyseal fracture of femur and tibia is an ideal method of surgical treatment with satisfactory results with minimum complications.
Material and Method: In this age group, we have evaluated total 50 patients, out of which 30 patients have fracture of shaft femur and 20 patients have fracture of shaft tibia. All children and adolescent patients between 5-16 years of age with diaphyseal fractures of femur and / or tibia admitted in tertiary center in government setup - meeting the inclusion and the exclusion criteria (as given below) during the study period were the subjects for the study. Patient were regularly followed up radiologically. Final outcome is measured with Flynn’s criteria.
Results: 68% of the patients were boys. Fall down was the most common mode of injury accounting for 28 (56.0%) cases Average duration of stay in hospital was 5.18 days. Superficial infection was seen in 1(2.0%) case. 1(2.0%) patient had shortening. Union was achieved in <3 months in 40 (80%) of the patients with average time to union being 11.9 weeks.
Conclusion: Because of early weight bearing, rapid healing and minimal disturbance of bone growth, Ender’s nail may be considered to be a physiological method of treatment.
Use of Ender’s nails for definitive stabilization of femoral and tibial shaft fractures in children is a reliable, minimally invasive, and physeal-protective treatment method. Our study results provide new evidence that expands the inclusion criteria for this treatment and shows that Ender’s nails can be successfully used regardless of fracture location and fracture pattern.