Naveen Raj K, Venkateswarlu Kurukunda, Nagaraju Madiga, Shyamdhar Tirumuru, Mahesh Sagar Athinarapu, Srikar Jakkala
BACKGROUND The technique of titanium elastic nailing system was developed by Metaizeu and the team from Nancy in 1982 which brought a major change in the treatment of paediatric long bone fractures. A lot of interest has been generated over the surgical treatment of paediatric long bone fractures. But there has been a lot of debate over operative indications in the children less than 6 years and adolescents greater than 16 years. Several treatment methods such as traction followed by hip spica, external fixation, flexible, stable intramedullary nails, plate fixation, and locked intramedullary nailing are available for the age group between 6 to 16 years. Any treatment method can be chosen, but the ultimate goal should be to stabilize the fracture, to control length and alignment, to promote bone healing, and to minimise the morbidity and complications for the child and his/her family. Initially titanium elastic nail (TEN) fixation was used as an ideal treatment method for femoral fractures; later, this technique was gradually applied to other long bone fractures in children, as it represents a compromise between conservative and surgical therapeutic approaches with satisfactory results and fewer complications. MATERIALS AND METHODS Study was conducted in 30 children from October 2016 to April 2018 who underwent fixation with titanium intramedullary nails for long bone fractures. The age group of children was 6 to 12 years. Mean age group was 10.33 years. There were 16 femoral, 10 tibial, 2 forearm and 2 humeral fractures. Majority of patients were operated with in first week. Average operating time was 45 minutes. Average blood loss was 55 ml. Mean duration of hospital stay was 5 days. Follow up was done for a period of 6 months. RESULTS Patients were evaluated using Flynn’s criteria. All patients achieved complete healing at a mean duration of 10 weeks. Good to excellent results were obtained in 90% of patients and 10% of patients had fair results. Knee stiffness was seen in 4 cases, shortening was seen in 1 case, malunion was seen in 1 case. No cases of non-union were seen. CONCLUSION Titanium elastic nailing is the method of choice for paediatric patients, because it is minimally invasive, less traumatic and simple method. It shows very good functional and cosmetic results. Early ambulation of patient is an advantage
