Role of flexible elastic nails in diaphyseal fractures of long bones of lower extremities in children of 5-14 years of age

Abstract

Femoral and tibial fractures are common long-bone injuries in children. Above five years of age all such fractures, when treated conservatively could lead to loss of reduction, malunion, intolerance and complications associated with plaster. The goals are to stabilize the fracture, to control length and alignment. Flexible Elastic Nailing has become the choice of stabilization in paediatric long bone fractures. The aim of our study was to see the outcome of Flexible elastic nailing system in diaphyseal fractures of children of 5-14 years age. The study included total of 50 children treated with flexible elastic nailing system and they were followed up at 3, 6, 12 and 24 weeks. The average duration of callus formation was 3.8weeks (4.2weeks in Tibia & 3.4 weeks in femur). Radiological union was seen in a mean time of 9.65 weeks. Full weight bearing was possible in a mean time of 10 weeks. According to flynn's scoring criteria, excellent and satisfactory results were in 90% and 10% respectively. There were 2 cases of post-operative superficial infection which resolved with regular dressing and no cases of physeal injury and implant failure. Flexible elastic nail is a safe and satisfactory mode of treatment and is relatively easy to perform in disphyseal fracture of femur and tibia in children. It avoids the chances of physeal injury, infection and offers early mobilisation and rapid healing.