Evaluation of outcome of titanium elastic nailing (TEN) versus hip spica cast in the treatment of femoral shaft fractures in children

Kumar, Raj; Kumari, Anupma; Pandit, Abhishek

doi:10.22271/ortho.2018.v4.i4c.26

Cited by 4 publications

(8 citation statements)

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“…The demographic detail is provided in table I. 10 With a male to female ratio of 1.9:1, we saw that these kids were overwhelmingly male. Similar male predominance among these children has also been documented by a number of national and international research.…”

Section: Resultsmentioning

confidence: 99%

Mean independent walking time for children with Femoral Shaft fractures using Titanium Elastic Nailing VS Hip Spica Cast treatment

Fazal

2023

Isra Med J

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Objective: To investigate the mean amount of time it took children with Hip spica casts versus titanium elastic nailing for the treatment of femoral shaft fractures to walk independently. Design: Retrospective cohort study. Place and Duration of Study: From 1st September 2021 to 31st September 2022 at Department of Orthopedic Surgery, Benazir Bhutto Hospital, Rawalpindi. Methodology: A study on 60 pediatric patients suffering from femoral shaft fractures of both genders aged four till eight years of age using convenient sampling. Results: The patients' average age was 5.58 ±1.24 years. There were 39 (65.0%) male and 21 (35.0%) female patients in the study group with a male to female ratio of 1.9:1. Compared to hip spica casts, children treated with titanium elastic nails had a considerably shorter mean time to walk independently (5.60±1.28 weeks vs. 8.93±1.98 weeks; p-Value = 0.001). Numerous patient subgroups based on age, gender, and weight showed similar statistically significant variations among the cohorts. Conclusion: In terms of considerably reducing the mean time to walk freely, this study found that titanium elastic nailing is preferable to the traditional method of hip spice cast. Future orthopaedic practice should prioritise the titanium elastic nails to be used in the fractures of this kind because to their minimally invasive nature, improved patient hygiene, and aesthetic appearance. Keywords: Shaft of femur, Fracture, Elastic Nailing, Hip Spica Cast, Walking time. How to Cite This: Shahid R, Haider M, Talib A, Butt NS, Mirza AN, Fazal F. Mean independent walking time for Children with Femoral Shaft fractures using Titanium Elastic Nailing VS Hip Spica Cast Treatment. Isra Med J. 2023; 15(2): 47-50. DOI: https://doi.org/10.55282/imj.oa1382

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Section: Resultsmentioning

confidence: 99%

Mean independent walking time for children with Femoral Shaft fractures using Titanium Elastic Nailing VS Hip Spica Cast treatment

Fazal

2023

Isra Med J

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“…This also enhances fracture healing and lessens the risk of infection. Kumar R et al 9 found TEN superior over hip spica, the non-operative procedure carried out in the treatment of diaphyseal femoral fractures in children. Similarly, Shemshaki HR et al 23 found that TEN has advantages over hip spica in their comparative study.…”

Section: Discussionmentioning

confidence: 99%

“…The results were evaluated using Flynn scoring criteria. 9 Routine removal of these implants was recommended 6-9 months after surgery when the fracture line was no longer visible radiologically.…”

Section: Surgical Techniquementioning

confidence: 99%

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Outcome of Titanium Elastic Nailing in the Surgical Management of Femoral-Shaft Fracture in Children

2020

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Introduction: Femoral shaft fracture is one of the most common orthopedic injuries of the children. These fractures treated non-operatively by traction followed by hip spica require prolonged hospitalization causing undue physical and psychological stress for patient and patient family. Loss of reduction is also commonly seen with hip spica that leads to unacceptable complications like angular deformities and limb length discrepancies. Titanium Elastic Nailing (TEN) is becoming widely accepted treatment for femoral shaft fractures in children due to its simplicity and physeal protective stable load sharing construct that allows early mobilization. The purpose of this study was to see the outcome of operative treatment of femoral shaft fracture in children by TEN. Methods: A retrospective observational study was carried out in the Department of Orthopedics in National Academy of Medical Sciences, National Trauma Center from February 2017 to January 2019. Study was undertaken in 22 children between the age group of 5-14 years with femoral shaft fractures. Fixation with TEN was done for all fractures within nine days of injury. Patients were assessed radiologically as well as clinically until fractures healed. The results were evaluated using Flynn scoring criteria. Results: Radiological union was seen in all cases between 6–12 weeks after surgery. The mean operating time was 58 (48-115) minute and mean hospital stay after surgery was 9 (6-15) days. Results were excellent in 14 patients (63.63%), satisfactory in 6 patients (27.37%) & poor in 2 patients (9%). Six patients had skin irritation at nail insertion site which resolved after removal of nails. Functional range of motion in both hip and knee joints of affected limb was preserved in all cases after the removal of nails. Conclusion: TEN is an effective and safe treatment of femoral shaft fractures in children of 5-14 years of age group.

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“…It is relatively uncommon as compared to the adult population, although it's occurrence poses a high burden in morbidity in terms of cost and time of treatment (3). Paediatric femoral shaft fracture affects children's life individually, socially, educationally and emotionally, (4) and also can contribute to long-term disability (5).…”

Section: Introductionmentioning

confidence: 99%

Pattern, treatment modalities and radiological outcome of pediatric femoral shaft fractures treated in Northern,Tanzania

Kilawa,

Pallangyo,

Maya

et al. 2024

Preprint

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BackgroundFemoral shaft fracture is among the most common causes of paediatric hospitalisation, mortality and morbidity worldwide. There is no clear option that is preferable to other treatment modalities, especially between 5 to 16 years and published studies are scarce on radiological outcomes in Sub-Saharan Africa.This study aimed to determine the pattern, treatment modalities and radiological outcome of the paediatric femoral fractures treated at KCMC.MethodologyA cross-sectional study was conducted for all children with femoral shaft fractures treated at Kilimanjaro Christian Medical Centre from 1stJanuary 2018 to 31stDecember 2022. The approval to conduct the research was obtained from Kilimanjaro College Research Ethics and Review Committee (CRERC) with ethical clearance Reg NO PG 88/2022. In our study we used secondary data and the permission to conduct the research was obtained from KCMC, hence no formal consent was required from patients/parents.The data was accessed from the files and Elecronic Health Management system (EHMS) from 01/04/2023 to 31/07/2023.The radiological outcome; shortening, angulations in six weeks and fracture union, 12 weeks post-management were reviewed with the involvement of a consultant radiologist and the orthopaedic surgeon to obtain the precise information and were recorded on the extraction sheet.ResultsThis study included 230 study participants who met the inclusion criteria. The mean age of participants was 9.1 (5.1) years, 41.3%, was aged 6 – 12 years, 82.2% were males, 45.7% were involved in a MTC, and 83.5% had no health insurance. The commonest fracture type was 92.6% closed, 48.7% transverse, and 65.% right side. Non-operatively was used in 50.9% of which 76.8% were treated with late hip Spica. Of those treated operatively, 61.1% were plating.The majority had good radiological outcomes with acceptable solid union, angulation and shortening. Those patients who were not operated had 94% lower odds of satisfactory radiological outcomes than those who were operated ( AOR=0.06, 95% CI: 0.01 – 0.27 and p<0.001) whereas other factors were not statistically significant.ConclusionThe majority of the study participants were male and were involved in MTC as the commonest mechanism of injury. Most had closed fractures that mainly presented on the right side and transverse fractures were the most common type. The hip Spica was common non-operatively option; however, plating was the most common operative option. Treatment modality substantially affected radiological outcomes and was statistically significant.

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Evaluation of outcome of titanium elastic nailing (TEN) versus hip spica cast in the treatment of femoral shaft fractures in children

Cited by 4 publications

References 12 publications

Mean independent walking time for children with Femoral Shaft fractures using Titanium Elastic Nailing VS Hip Spica Cast treatment

Mean independent walking time for children with Femoral Shaft fractures using Titanium Elastic Nailing VS Hip Spica Cast treatment

Outcome of Titanium Elastic Nailing in the Surgical Management of Femoral-Shaft Fracture in Children

Pattern, treatment modalities and radiological outcome of pediatric femoral shaft fractures treated in Northern,Tanzania

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