Assessment Of Outcome Of Pediatric Diaphyseal Femur Fractures Treated With Elastic Stable Intramedullary Nails In Gandaki Medical College

Abstract

Introduction : Various techniques described for managing pediatric femur fractures include closed reduction and internal fixation (CRIF) with elastic nails, open reduction and internal fixation (ORIF) with compression plates, external fixators, and skeletal traction with spica casting. Although flexible intramedullary nailing has emerged as an accepted procedure for pediatric femur diaphyseal fractures, it is not free from complications, including pin site irritation, limb length discrepancy, superficial infection, and synovitis. This study aims to assess the complications and outcomes following the treatment of femoral shaft fractures using titanium elastic nails.

Methods : A prospective observational study was conducted with 25 children aged 5 to 15 years, admitted with diaphyseal femur fractures at Gandaki Medical College and Teaching Hospital, Pokhara. All patients were treated with fracture reduction and internal fixation using titanium elastic nails and followed up until fracture union (ranging from 3 to 6 months). The functional outcomes were assessed using the Flynn Scoring System.

Results : This study included 25 patients admitted with diaphyseal femur fractures and treated with titanium elastic nails. Radiological union was achieved at an average of 8.8 weeks. Of the total 25 patients, 21 (84%) had an excellent outcome, while 4 (16%) had a satisfactory outcome.

Conclusion : We concluded that the Elastic Stable Intramedullary Nail (ESIN) system, when used for the fixation of pediatric femoral shaft fractures, provides a successful outcome with a low complication rate.