Key result
Titanium elastic nails significantly reduced the mean time to walk independently compared to hip spica cast in children with femoral shaft fractures (5.60 vs. 8.93 weeks; p<0.001).
Why the study?
The study aimed to compare functional outcomes in children with femur shaft fractures treated with either titanium elastic nails or spica cast application.
Does titanium elastic nail reduce the time to walk independently compared to hip spica cast in children aged 3-6 years with femoral shaft fractures?
RCT (n=60)
randomly allocated
No
Does titanium elastic nail reduce the time to walk independently compared to hip spica cast in children aged 3-6 years with femoral shaft fractures?
Absolute Event Rate: 5.6% vs 8.93%
p-value: p=<0.001
In children aged 3-6 years with femoral shaft fractures, treatment with titanium elastic nails significantly reduces the time to walk independently compared to a hip spica cast.
TEN may accelerate independent walking in young children with femoral shaft fractures; leaves open whether it should supplant spica casting in routine practice.
This study aimed to compare functional outcomes in children with femur shaft fractures treated with ether titanium elastic nail or spica cast application. This prospective cohort study was conducted at the Department of Orthopedic and Spine, Aziz Bhatti Shaheed Teaching Hospital, Gujrat, from 1st June 2020 to 31st December 2022. This study involved 60 children of both genders, aged 3-6 years, presenting with femoral shaft fractures (Winquist I & II), randomly allocated into two groups for treatment. Patients in Group E were treated with titanium elastic nails, while a hip spica cast was applied to patients in Group S. Functional outcome was measured with the meantime to walk independently, which was noted and compared between the two groups. Patients had a mean age of 4.42±1.12 years, while the mean weight was 18.23±2.09 Kg. There were 21 (35.0%) female and 39 (65.0%) male patients with a male-to-female ratio of 1.9:1. The mean time to walk independently was significantly shorter in children treated with titanium elastic nail as compared to hip spica cast (5.60±1.28 vs. 8.93±1.98 weeks; p<0.001). A similar significant difference was observed between groups across various subgroups of patients based on age, gender, and weight. We concluded that internal fixation of pediatric femoral shaft fractures utilizing titanium elastic nail had superior functional outcomes as compared to hip spice cast application in terms of significantly shorter mean time to walk independently along with the minimally invasive nature of the procedure and better patient hygiene and cosmesis advocate preferred use of titanium elastic nails for management of such fractures.
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SIDDIQ et al. (2023) conducted an RCT in femoral shaft fractures (Winquist I & II) (n=60). Titanium elastic nails vs. Hip spica cast was evaluated on mean time to walk independently (p=<0.001). Titanium elastic nails significantly reduced the mean time to walk independently compared to hip spica cast in children with femoral shaft fractures (5.60 vs. 8.93 weeks; p<0.001).
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