A Comparative Study of Titanium Elastic Nailing System versus Spica Casting in Management of Femoral Shaft Fractures in Pediatric Age Group
Journal Title: Journal of Bone and Joint Diseases - Year 2018, Vol 0, Issue 0
Abstract
Background: Nearly 70% of femoral fractures involve the shaft and representing 1.6% of all fractures in the pediatric population. Aim: e aim of the study was to study and compare the results of titanium elastic nail (TEN) and spica cast in the management of femoral shaft fractures in pediatric age group (0–10 years). Methods: This was a prospective study conducted in the Department of Orthopedics, Maharani Laxmi Bai Medical College and Hospital, Jhansi, Uar Pradesh, India, over a period of 18 months. 90 patients were included in the study of which 63 treated by titanium elastic nailing system (TENS) nailing and rest by spica casting. Results: Ninety patients were included in this study, of which there were 51 boys and 39 girls (M/F ratio 56.52, mean age 7.9 years, and range 0–10 years). Union was seen in all the cases. Of the 63 children in the TENS nailing group, 8 (12.69%) had so tissue irritation at the insertion point. Of the 27 children in the spica cast group, 5 (18.52%) children required re-manipulation and casting due to loss of reduction with unaccepted angulation and rotation, plaster sore in 2 (7.40%) patient and limitation of range of movement in 3 (11.11%) patients. Conclusion: Elastic intramedullary nailing is superior to spica casting because of less malunion and shortening rate and early range of motion with the strengthening of an injured limb with very few complications for treating pediatric femoral shaft fracture. TEN treatment is superior to spica casting for children who had reached an average age of 4 years.
Authors and Affiliations
Saurabh Agarwal, Raghvendra Pratap Singh
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