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 bearing 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.


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