Elastic Stable Intramedullary Nailing and Fixation with Titanium Elastic Nail in Displaced Femoral Shaft Fractures in Children

Introduction: Femoral shaft fracture is an incapacitating injury in children. The treatment has traditionally been age related, influenced by the type of injury, associated injuries and the location and type of fracture. The aim of fracture treatment is not only anatomical realignment, but also restoration of muscle and joint function as close as possible to the normal. Objective: To evaluate the elastic stable intramedullary nailing and fixation with titanium elastic nail in displaced femoral shaft fractures in children. Material and Methods: A Retrospective Study conducted at Dept. of Ortho-Surgery, Patuakhali Medical College Hospital, Patuakhali, Bangladesh from January 2022 to June 2022. Forty six peadriticpatientsfemoral shaft fractures were included. Results: Total 46 children (36 males, 10 females) having age between 6-14 years with fresh femoral shaft fractures which were fixed with Titanium Elastic Nail. All patients achieved complete healing at a mean of 9.1 (Range 810) weeks. 41 fractures were reduced by closed means but 5 needed open reduction. The mean duration of surgery was 38 (range 30- 45) minutes. The size of nail varied from 2- 4 mm. The mean duration of hospital stay was 8.16 (range 7-12) days. The mean time of the union was 7.9 (range 79) weeks. Full weight bearing was possible in a mean time of 8.6 (range 7-10) weeks. All the patients achieved full range of motion by an average of 9.6 (range 8-11) weeks. No major complication was recorded. Most common minor complication was entry site skin irritation recorded in 6 patients. 87% had excellent result and 13% had satisfactory. Conclusion: It is concluded that Elastic Intramedullary Nailing of Femur Shaft Fractures in Children have excellent outcome with minimal complications. Elastic stable intramedullary nailing is the method of choice for the femoral shaft fractures in paediatric patients, because it is minimally invasive and shows very good functional and cosmetic result. It allows early ambulation and shorter hospital stay and higher parent satisfaction. It also provides flexural, translational and rotational stability as well