Functional Outcome of Pediatric Long Bone Fractures in Children by Closed Reduction and Internal Fixation with Titanium Elastic Nails

Abstract

Background

Childhood injury is most common among the children in age of 5- 16 years. Most of the fractures are not detrimental but, few require immense care to avoid future problems. The worldwide data analysis showed that there is a rising in fracture related death in children population. Thus, those fractures alarm the need of concerned treatment methods for healthier life of those children.

Materials and Methods

Thirty-one patients with fractures of the femur (12), tibia (9), radius/ulna (6), clavicle (2), humerus (2) were treated with titanium elastic nailing between May-2015 to June-2017 at Sri Lakshmi Narayana Institute of Medical Sciences Hospital, Pondicherry. Children and adolescents aged between 3 to 17 years were included in the study.

Results

Among the patients. 35.48% of patients were between 3-8 years, (32.48%) in 912 years, (32.26%) in 13-17 years of age group with the average age being 9.8 years. 77.42% of the patients were boys. RTA/self-fall was the most common mode of injury accounting for 15 (48.39%) cases each, battered baby accounted for 1(3.22%). Transverse fractures accounted for 14(45.16%) cases, oblique fractures 9(29.03%) and spiral fractures 8(25.81%). Fractures involving the middle 1/3rd accounted for 24 (77.42%) cases. All the patients were prepared and operated as early as possible once the general condition was stable and the patient was fit for surgery. The average duration between trauma and surgery was 11 days with 20 (64.52%) patients undergoing surgery within <48 hrs and 11 (35.48%) patients undergoing surgery more than > 48 hrs. Average duration of stay in hospital was 12 days.

Conclusion

The development of the TENs fixation method has put an end to criticism of the surgical treatment of paediatric long bone fractures, as it avoids any growth disturbance by preserving the epiphyseal growth plate, it avoids bone damage or weakening through the elasticity of the construct, which provides a load sharing, biocompatible internal splint, and finally it entails a minimal risk of bone infection.