International Journal of Research in Orthopaedics | January-February 2019 | Vol 5 | Issue 1 Page 1
International Journal of Research in Orthopaedics
Bahinipati J et al. Int J Res Orthop. 2019 Jan;5(1):xxx-xxx
http://www.ijoro.org
Original Research Article
Observational study on titanium elastic nailing in femoral shaft
fractures in children
Jyotirtmayee Bahinipati
1
, R. G. Asutosh Mohapatra
2
*
INTRODUCTION
Fracture of shaft of femur is a common fracture in
children, which has usually been treated conservatively.
In children, fractures of femoral shaft are commonly
treated by various types of traction for about three weeks,
followed by plaster cast immobilization.
1
This safe form
of treatment has two major drawbacks. The first is that
prolonged bed rest separates the child from his normal
environment; the second is the cost of such periods in
hospital and the use of beds which might serve other
patients. Because of rapid healing and spontaneous
correction of angulations, most of the femoral shaft
fractures in children younger than five years of age can
be treated conservatively. But, above six years of age,
such fractures when treated non operatively could have,
loss of reduction, malunion, intolerance and
complications associated with plaster. Near the end of
skeletal maturity, accurate reduction is necessary as
angular deformity is no longer correctable by growth.
2
Therefore, the best treatment in older child i.e. between
five to fifteen years of age is a matter of debate. Since the
last two decades, there has been a growing tendency
towards an operative approach in femoral shaft fractures
in children of school going age. Successful treatment
with external fixation, plating and solid ante grade
intramedullary nailing has been reported. However, the
risk of certain complications (particularly pin track
infection and refracture after external fixation or
avascular necrosis after solid antegrade intramedullary
nailing) has prevented these methods from becoming
adopted as the best treatment.
ABSTRACT
Background: Nowadays femoral fractures in children are more commonly managed with operative fixation rather
than conservative treatment because of more rapid recovery and avoidance of prolonged immobilization. Our aim of
study was to assess the outcome of titanium elastic nailing in femoral shaft fracture in children.
Methods: Twenty five children in age group 5-15 years with femoral shaft fracture were stabilized with two titanium
nails. Children were followed up for one year. The operative outcome was evaluated using criteria of Flynn.
Complications associated with procedure were recorded and analyzed.
Results: The final outcome was excellent in 67% (19 of 25) of patients, satisfactory in 16% (4 of 25) of patients and
poor in 8% (2 of 25) of patients. Poor outcome was due to limb length discrepancy, pain in the knee and angular
misalignment.
Conclusions: We concluded that titanium elastic nailing is an ideal method of femoral shaft fixation in children.
Keywords: Femoral shaft fractures, Children, Titanium elastic nailing
1
Associate Professor, Department of Biochemistry, KIMS, Bhubaneswar, Odisha, India
2
Assistant Professor, Department of Orthopaedics, S.C.B. Medical College, Cuttack, Odisha, India
Received: 02 December 2018
Revised: 17 December 2018
Accepted: 18 December 2018
*Correspondence:
Dr. R. G. Asutosh Mohapatra,
E-mail: drkitusraban@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20185146