Comparison of the Outcome of Titanium Elastic Nail Versus Compression Plate in Diaphyseal Fracture of Femur in Children

Abstract

Introduction: Different fixation types have been described for thediaphyseal femur fractures in children, aged 5 to 15 years. The main aim of the study was to compare the functional and radiological outcome of closed reduction and internal fixation (CRIF) with Titanium elastic nailing system (TENS)(Group A) and open reduction and internal fixation (ORIF) with compression plate (Group B) for diaphyseal femur fracture in pediatric age.

Methods: This was a prospective comparative study. A total of 50 patients (25 each) were studied. The final follow- up was at 6 months and the final data was taken.

Results: The mean operative time and mean blood loss in group A and group B was 58.80±6.96 vs 106.4.2±11.13min (p< 0.01) and 26±5.74 ml vs 118.8±13.56 ml. (p<0.01) respectively. Except for two cases of implant failure, 48 patients showed union by the last follow-up. The average time to union was 10.56 ± 4.98 weeks vs 14.09 ± 4.6 weeks in groups A and B respectively. There were significantly higher complications in group B (p= 0.01). The functional outcome was comparable between groups (p =0.129).

Conclusions: The functional outcome was comparable between the closed reduction and TENS groups and the open reduction and plate group. But closed reduction and TENS could be better in pediatric femur fracture surgical treatment as it had shorter operating time and union time, less intraoperative blood loss, and post-operative complications with better knee range of motion than open reduction and plating.