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} </script> <script src="//translate.google.com/translate_a/element.js?cb=googleTranslateElementInit"></script> </ul> </div> </nav> <div class="container-fluid bg-grey"> <div class="container pt-3 pb-4"> <div class="white-container mt-4"> <h2 class="bg-hdr">Titanium Elastic Nails in the Treatment of Pediatric Femur Fractures - Case Series</h2> <p style="padding-top: 8px;"><strong><span lang="NE">Background:</span></strong> <span lang="EN-IN">Paediatric femoral fractures are treated by a variety of method</span><span lang="NE">. </span><span lang="EN-IN">The choice of treatment may be influenced by the age of the child, the level and pattern of the fracture and to a great extent, by regional, institutional or surgeons` preferences</span><span lang="NE">. </span><span lang="EN-IN">A systematic review of the literature provides little evidence to support one method of treatment over another</span><span lang="NE">.</span></p> <p style="padding-top: 8px;"><strong><span lang="NE">Objectives:</span></strong><span lang="EN-IN"> Th</span><span lang="NE">e aim of the</span><span lang="EN-IN"> study </span><span lang="NE">was </span><span lang="EN-IN"> to evaluate the efficacy of </span><span lang="NE">Titanium elastic nails( </span><span lang="EN-IN">flexible intramedullary</span><span lang="NE">)</span><span lang="EN-IN"> as a fixation device of paediatric femoral shaft fractures</span><span lang="NE">. </span></p> <p style="padding-top: 8px;"><span lang="NE"><strong>Methods:</strong> This is retrospective interventional study done at the department of Orthopaedics,B.P.Koirala Institute of Health Sciences,Dharan,Nepal over a period of 2 years from March 2007 to April 2009.</span><span lang="EN-IN"> A total of </span><span lang="NE">45</span><span lang="EN-IN"> children with </span><span lang="NE">45 </span><span lang="EN-IN">closed fractures were treated by this method. The patient’s age ranged from </span><span lang="NE">6 </span><span lang="EN-IN">to </span><span lang="NE">12</span><span lang="EN-IN"> years and the mean follow-up was </span><span lang="NE">18 weeks</span><span lang="EN-IN">. All patients had open femoral growth plates at the time of surgery</span><span lang="NE">. </span></p> <p style="padding-top: 8px;"><strong><span lang="NE">Results:</span></strong><span lang="EN-IN"> The study co</span><span lang="NE">mprised </span><span lang="EN-IN">of </span><span lang="NE">45</span><span lang="EN-IN"> children with </span><span lang="NE">45 </span><span lang="EN-IN">femoral shaft fractures. The age incidence in this series ranged from </span><span lang="NE">6 </span><span lang="EN-IN">years to 12 years (an average of </span><span lang="NE">9</span><span lang="EN-IN"> years)</span><span lang="NE">. Thirty </span><span lang="EN-IN">children were males and </span><span lang="NE">fifteen</span><span lang="EN-IN"> were females. All the fractures in this series were recent closed fractures. The fracture pattern was transverse or short oblique in </span><span lang="NE">fourty </span><span lang="EN-IN">cases</span><span lang="NE">, Spiral in three cases </span><span lang="EN-IN">and comminuted in </span><span lang="NE">two</span><span lang="EN-IN"> cases. </span><span lang="NE">25 </span><span lang="EN-IN">fractures occupied the middle third</span><span lang="NE">, 9 fractures occupied distal third and 1 fracture upper third</span><span lang="EN-IN"> of the femur. The mechanism of injury included falls </span><span lang="NE">from height </span><span lang="EN-IN">(60%), motor vehicle accidents (28%) and </span><span lang="NE">sports related injury </span><span lang="EN-IN">(12%). </span></p> <p style="padding-top: 8px;"><strong><span lang="NE">Discussion: </span></strong><span lang="EN-IN">Paediatric femoral fractures are treated by a variety of methods including traction, immediate spica cast, traction followed by spica cast, internal fixation with plate and screws, external fixation and intramedullary fixation</span><span lang="NE">. The indications for Titanium elastic nail for fixation of paediatric femoral shaft fractures are expanding as their advantages are realized and complications of other operative methods of stabilization are reported. Compression platings are associated with high incidence of refracture. External fixators are associated with pin tract infection, loss of reduction, refracture after removal of external fixator and rigid intramedullary nailing are associated with greater trochanter physis leading to growth arrest with subsequent coxa valga. It is also associated with damage to blood supply of femoral head leading to osteonecrosis of femoral head.These problems and complications are overcome by introduction of flexible intramedullary nailing(TENS) for treatment of paediatric femoral shaft fractures with following advantages. Our results are compatible with results of other series of TENS in terms of union, no implant failur,no refracture after implant removal, within acceptable limb length descrepancies</span></p> <p style="padding-top: 8px;"><strong><span lang="NE">Conclusion:</span></strong> <span lang="NE">Titanium elastic nail </span><span lang="EN-IN">is an excellent method of managing most, but not all, paediatric femoral fractures that need operative stabilization</span><span lang="NE">.</span><span lang="EN-IN"> It is by no means the only technique nor is there evidence yet that it is superior to other methods. Its advantages make it a valuable choice to consider in managing these fractures. </span></p> <p style="padding-top: 8px;"><span lang="EN-IN">Keywords</span><span lang="EN-IN">: <a title="Search for this keyword within this periodical." href="http://www.injuryjournal.com/search/quick?search_area=journal&search_text1=Flexible%20nails&restrictName.jinj=jinj">Flexible nails</a>, <a title="Search for this keyword within this periodical." href="http://www.injuryjournal.com/search/quick?search_area=journal&search_text1=Femoral%20fractures&restrictName.jinj=jinj">Femoral fractures</a>, <a title="Search for this keyword within this periodical." href="http://www.injuryjournal.com/search/quick?search_area=journal&search_text1=Childhood&restrictName.jinj=jinj">Childhood</a></span><span lang="NE">,</span></p> <p style="padding-top: 8px;"><span lang="NE">P </span><span lang="EN-IN">Chaudhary</span><span lang="EN-IN">, </span><span lang="NE">B.P Shrestha, G.P </span><span lang="EN-IN">Khana</span><span lang="NE">l, R Maharjan.</span></p> <p style="padding-top: 8px;"><span lang="EN-IN">Department of orthopaedics, B.P.Koirala Institute of Health sciences, Dharan, Nepal</span></p> <div class="border-top py-2"><b>Posted by: </b>Dr. Pashupati Chaudhary, Add. 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