Flexible Intramedullary Nails for Fixation of Adolescent Diaphyseal Tibial Shaft Fractures

Background: Diaphyseal tibial shaft fractures are the second most common fracture in hospitalizedchildren resulting from both high and low energy trauma. Operative treatment requires implants that donot violate open physes and have less complications rate than traditional treatment methods. Flexibleintramedullary nails had gained popularity for treatment of paediatric diaphyseal tibial shaft fractures.Patients and Methods: 45 patients with diaphyseal tibial fracture were treated by flexible intramedullarynails. There were 30 male and 15 females. The youngest patient in our study was 10 years old while theoldest was 18 years old. Functional and radiological evaluations were done for all patients at the lastfollow up. Results: Most common mechanism of injury was road traffic accident followed by falling fromheight. 62.2 % of the cases had simple fracture (28 patient) while 26.7% of cases (12 patients) had type Iopen fractures and 11.1 % of the cases (5 patients) had type II open fractures. All fractures achieved fullfracture union at a mean of 12 week with range from 10 to 18 week. Two cases suffered from nonunionthat treated later on by bone grafting. One patient had postoperative fracture angulation. Conclusion:Flexible intramedullary nails can be used safely in adolescents with satisfactory results. It providesacceptable fracture redction and rapid healing with an acceptable rate of complications and return tounrestricted physical activity.