Functional Outcome of Paediatric Subtrochanteric Femur Fracture Treated with Titanium Elastic Nails
Journal Title: Journal of Orthopaedic Education - Year 2019, Vol 5, Issue 1
Abstract
Introduction: Subtrochanteric femur fractures are the commonest paediatric fractures. These fractures are quite challenging injuries to treat. Intramedullary nails though have been used to treat paediatric femur shaft fractures, their effectiveness for managing the subtrochanteric fractures are of doubt. Aim: The union rates and fracture alignment after elastic nailing of paediatric subtrochanteric femur fractures. Materials and methods: The study was conducted between June 2016 and Dec 2017, in which 22 subtrochanteric fractures were treated with elastic stable intramedullary nails and were followed up for clinical and radiographic union. For subtrochanteric fractures especially after failed spica cast treatment in children of 5 to 15 years age group, elastic nailing was used. Fracture union and alignment were measured clinically and radiographically. Results: Among the 22 cases, 09 were female cases and 13 were male cases. Out of this, 20 fractures were healed with acceptable complications which included malunion (n = 4), loosening of nails (n = 2), re-fracture (n = 1), wound dehiscence at the nail insertion site (n = 1) and limb length discrepancy (n = 1) and only 2 (6%) had poor outcomes. Hence on overall, there were 13 (61%) excellent, 7 (33%) satisfactory and 2 (6%) poor outcomes. Conclusion: Although complication rates were variable (40 %) with elastic nailing for paediatric subtrochanteric femur fractures, it represents an important option for complex subtrochanteric femur fractures.
Authors and Affiliations
Vasant Gawande
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