Internal fixation of pediatric shaft femur fractures by titanium elastic nails: clinical and radiological study

Background: Management of diaphyseal femoral fractures in the pediatric age group is challenging. There has been a demand worldwide for operative fixation. Methods: Twelve children (7 boys, five girls) aged 6-16 years with diaphyseal femoral fractures (12 fractures, one in each) was stabilized with titanium elastic nail system (TENS). Patients underwent surgery within a week days of their injury. The results were evaluated using Flynn's Scoring system. Identical two nails were used in each fracture. Results: All 12 patients were available for evaluation and follow-up for a mean duration of 24 months (14-34 months). Radiological union in all cases was seen at a mean duration of 8 weeks. Full weight bearing was possible at a mean duration of 10 weeks (8-12 weeks). The results were excellent in 8 patients (67%) and satisfactory in 4 patients (33%). Complications that occurred were infection (2 cases), knee joint stiffness (4 cases), angulation <10 degrees (1 case), and shortening less than 10 mm (2 cases). Conclusions: Intramedullary fixation by TENS is an effective, time-tested treatment of fracture of the femur in patients of the 6-16 years age group.