BACKGROUNDPaediatric fractures are usually treated conservatively with POP casts, as intramedullary nailing is contraindicated in growi ng bones and plating is associated with wound complications. These fractures heal satisfactorily with conservative treatment but may be associated with malunion and plaster complications sometimes. Titanium Elastic Nailing System (TENS) can be used in the internal fixation of paediatric fractures with satisfactory results and minimal complications. We wanted to study the functional outcome following the use of Titanium Elastic Nailing for the treatment of diaphyseal fractures of long bones in children. METHODS30 patients were treated with Titanium Elastic Nail System (TENS) for diaphyseal fractures of long bones who were admitted in Osmania General Hospital, Hyderabad during the study period-from October-2014 to October-2016. Patients were assessed clinically, radiologically and the complications were noted. RESULTSWe studied 17 (56.7%) femoral, 7 (23.3%) tibial fractures, 1 (3.3%) humeral and 5 (16.6%) forearm bone fractures. Average age of the patients is 10.93. In our study, the final outcome was excellent in 22 (73.33%) cases, satisfactory in 8 (26.67%) cases and there are no poor outcome cases.
BACKGROUNDIn bicondylar tibial plateau fractures, the most frequently used treatment is ORIF with screws and plates; however, the soft tissue complications are frequently reported. Minimally-invasive Ilizarov technique is an alternative. The purpose of this study was to compare and analyse the clinical and radiological results of locking plate and Ilizarov technique in bicondylar tibial plateau fractures treated at a level I trauma centre. MATERIALS AND METHODSThe patients with closed isolated bicondylar tibial fractures (Schatzker V/VI) were included in the study. Fifteen patients (8 of type V and 7 of type VI) in one group were treated using locked plating system and fifteen patients (5 of type V and 10 of type VI) in another group were treated with Ilizarov technique. Pre-and post-operatively, conventional radiographs, CT scans, hospital stay and complications were evaluated. The outcomes were evaluated using modified Rasmussen clinical and radiological criteria. RESULTSThe two groups were similar demographically. Both the techniques achieved acceptable osseous reduction. When compared with internal fixation, Ilizarov had increased average range of motion (124˚ vs 117˚), decreased complications (p= 0.01), reduced hospital stay (0.001), earlier weight-bearing and marginally faster recovery (outcome in terms of modified Rasmussen clinical assessment score) at 6 months. But the outcomes were not significantly different at 1 year. In this study, Ilizarov technique had slight favourable outcome compared to locked plating group. CONCLUSIONThe Ilizarov method produces a good clinical outcome and is a valuable alternative treatment for bicondylar tibial plateau fractures with added advantage of decreased hospital stay, decreased waiting time for definitive surgery and early weight bearing.
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