Functional outcome of femoral shaft fracture in pediatric patients treated by titanium elastic nailing system

Background: Pediatric femoral shaft fractures are common, typically occurring in early childhood due to low-energy incidents and during adolescence due to high-energy trauma. These fractures represent around 2.2% of all bone injuries in children, with an incidence of 20-25 per 100,000 children per year, and are more prevalent in boys. This prospective study aims to assess the outcomes of treating pediatric femoral shaft fractures with TENs. Methods: This prospective study at North Bengal Medical College and Hospital included Twenty-three patients, aged 4 to 12 years, with diaphyseal femur fractures treated using TENS (Titanium Elastic Nailing System) for one year, from January 2023 to December 2023. Results: Most patients (52.17%) were 9-12, with a higher prevalence of males (73.91%). The most common fracture type was transverse (69.57%), predominantly on the right side (69.57%). Union rates were 21.74% at 8 weeks, 56.52% at 10, and 21.74% at 12 weeks. Complications included limb lengthening (21.74%) and malalignment (13.04%). Functional outcomes at 12 weeks post-operation were mostly excellent (60.87%) or satisfactory (30.43%), with one poor result (8.70%). Conclusions: Titanium elastic nailing system (TENS) is effective for pediatric femoral shaft fractures, achieving high bone union rates and minimal complications. Most fractures healed within 10 weeks, and patients had excellent or satisfactory functional outcomes, supporting TENS as a beneficial treatment for children aged 4 to 14.