Functional outcomes of the stable elastic intramedullary nailing for the fractures of femur in children

Introduction: In current scenario, various operative procedures such as submuscular plating, spica casting, external fixation, intramedullary nailing etc available for children having femoral shaft fractures. We aimed to use titanium elastic nails for treating diaphyseal femoral fractures in children, considering the limited evidence of this technique. Our study focused on the efficacy, safety, average length of hospital stay and complications of this method. Materials & Methods: We recruited 20 patients aged 3-13 years with fracture shaft of femur and were treated with stable elastic intramedullary nailing with titanium elastic nails at Government Medical College, Kozhikode from February 2014 to January 2015. Follow ups were carried out at 6, 12 and 24 weeks and there after every 2 months till the fracture union was confirmed. Result: Out of 20 patents, 17 fractures were closely reduced & fixed and in 3 cases, open reduction was done. All the fractures united between 7-12 weeks, with average time of union being 8.3 weeks. All patients had good range of movements except 3 patients who had nail protrusion. The average duration of hospital stay was 7.3 days. Regarding the complications of this technique, limb length discrepancy was the most common complication. Conclusion: It was observed that Elastic Stable Intramedullary Nailing (ESIN) technique is an ideal method for treatment of pediatric femoral shaft fractures. It gives elastic mobility promoting rapid union at fracture site and stability which is ideal for early mobilization. It also has lower complication rate, permits early return to school when compared with other methods of treatment.