Ramasubba Reddy M1, Srinivasa Reddy Datla2, Priyank Uniyal3, Rakesh Reddy4
BACKGROUND: Orthopaedic surgeons have long maintained that all children who have sustained a diaphyseal fracture of femur recover with conservative treatment, given the excellent remodeling ability of immature bone in children. Angulations, shortenings and malrotations are not always corrected by conservative treatment. Of many surgical options, titanium elastic nailing has been the newer implant which is being used regularly. Although good results have been reported with elastic intramedullary nails, plate fixation continues to be a viable alternative in surgical treatment of femoral shaft fractures. However there are not many studies comparing the efficiency of titanium elastic nailing and plating for femoral diaphyseal fractures in pediatric age group. AIM: The present study aims to compare the surgical management of diaphyseal fractures of femur in children with Dynamic Compression Plating versus Titanium Elastic Nailing.
DESIGN: This is a prospective study. MATERIALS AND METHODS: This prospective study was conducted in a tertiary hospital. Patients who presented to the out-patient department and casualty of the hospital with femoral diaphyseal fractures during April 2012 to June 2014 were considered for the study. Subjects fulfilling the predetermined inclusion and exclusion criteria were included in the study. STATISTICAL METHODS: Fisher Exact test, Chi-Square Test, Student t test (Two tailed, independent).
RESULTS: Patients in the age group of 6-14 years were considered for the study, Patients were divided into two groups and treated with DCP/TENS. The duration of surgery, hospital stay, and, amount of blood loss was minimal in TENS group. Callus was seen early in TENS group. Radiological union was early in TENS group by 2-3 weeks. Outcome was better in patients treated with TENS (Excellent-70%; Satisfactory–30%; Poor-0%) in comparison to DCP (Excellent-70%; Satisfactory-25%; Poor-5%).
CONCLUSION: TENS is more versatile and can achieve biological fixation, with minimal complications compared to DCP hence it is concluded that TENS is better procedure for fracture shaft femur in children than DCP.
