TENS nailing in pediatric femoral diaphyseal fractures in the age group of 5-16 years.

Dr. Arjav Patel; Dr. Dhaval Modi

Volume : VIII, Issue : VIII, August - 2019

TENS nailing in pediatric femoral diaphyseal fractures in the age group of 5-16 years.

Dr. Arjav Patel, Dr. Dhaval Modi

Abstract :

Background: Management of femoral diaphyseal fracture in the age group of 5e16 years is controversial. The purpose of this study is to demonstrate the effectiveness of intra–medullary fixation of femoral shaft fractures by using titanium elastic nailing system (TENS). Materials and methods: Between April 2011 and April 2014, 40 pediatric patients (31 boys, 9 girls) aged 5e16 years with diaphyseal femoral fractures were treated by retrograde TENS fixation. Fractures were classified according to system of Winquest and Hansen as Grade–I (n 1⁄4 18), Grade–II (n 1⁄4 10), Grade–III (n 1⁄4 7) and compound fractures according to the Gustiloand Anderson‘s classification Grade–I (n 1⁄4 3), Grade–II (n 1⁄4 2). The final results were evaluated by using Flynn‘s criteria. Results: The mean duration of follow–up was 21 months (range 3e39 months). All fractures were radiologically united with grade 3 callus formation at 8e10 weeks period (mean 9 weeks) and full weight beå was possible in a mean time of 9.5 weeks. According to Flynn‘s criteria, excellent result was found in 33 patients (82.5%) and satisfactory in 7 patients (17.5%). Limb lengthening was noticed in 6 cases, varus mal–alignment was in 4 cases and rotational mal–alignment was seen in 3 cases. Peri–operative difficulties encountered were failure of closed reduction in 4 cases and cork screwing of nails in 2 cases. Conclusion: TENS is a safe and effective method for the treatment of pediatric femoral shaft fractures, because it is minimally invasive, relatively easy to use and shows very good functional and cosmetic results.