Analysis of Complications of Intramedullary Osteosynthesis with Titanium Elastic Nails in Fractures of Bones of Lower Extremities in Children

INTRODUCTION: The introduction of minimally invasive methods in clinical practice has significantly expanded the indications for surgical treatment of bone fractures in children. The method of osteosynthesis with titanium elastic nails is widely used at the age of 7 to 14 years and has many advantages. At the same time, the elastic-stable osteosynthesis has a number of probable complications and limitations. AIM: To analyze probable complications of the method of intramedullary osteosynthesis with titanium elastic nails in children of different age categories. MATERIALS AND METHODS: The results of treatment of 98 children with fractures of the long bones of the lower extremities were analyzed. All the patients underwent osteosynthesis with titanium elastic nails. The patients were divided to three age groups: 2 to 6 years, 7 to 13 and 14 to 16 years. Clinical and X-ray examinations of the patients were conducted. RESULTS: In young children, excellent results of treatment were obtained in 82.6% and satisfactory results in 17.4% of cases, no poor results were noted. In patients of the group 7 to 13 years, the results of treatment were considered excellent in 82.3%, and satisfactory in 17.7% of cases. In older children, outcomes of treatment were excellent in 62.5%, satisfactory in 29.2%, and poor outcomes that required repeated surgical interventions, were observed in 8.3% of cases. CONCLUSION: The most preferable age for osteosynthesis with titanium elastic nails was found to be from 6 to 14 years. There exist technical difficulties in use of this method in children of 2 to 4 years of age with "unstable in length" femoral bone fractures, nevertheless, the displacement of bone fragments was leveled out in all the observed cases. The greatest number of complications are associated with the use of TEN in the treatment of adolescents of 15 to 16 years due to insufficient rigidity of fracture fixation.