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Titanium Elastic Intramedullary Nailing in Paediatric Tibial Shaft Fractures

Byanjankar S, Shrestha R, Sharma JR, Chhetri S, Dwivedi R and Joshi RR

Introduction: Most of the pediatric tibial shaft fractures are treated non-operatively with close reduction and casting. Surgical indications include unstable fractures, open fracture, polytrauma patients, compartment syndrome or severe soft tissue injury. The purpose of this study was to assess the outcome of tibial shaft fracture fixation with titanium elastic intramedullary nails.
Patients and methods: The average age of the patient was 11.3 years (range 6 to 15 years) and mean follow up was 14 months (range 6 to 26 months). Patient’s charts and radiographs were reviewed retrospectively. The outcomes were classified as excellent, satisfactory or poor according to Flynn’s criteria for flexible nail fixation.
Results: All patients achieved union at a mean of 10.3 weeks (8 to 14 weeks). Full weight bearing was achieved at a mean of 9.2 weeks (8 to 14 weeks). At last follow-up, the result was excellent in 18 patients and satisfactory in 4 patients. Nineteen patients had less than 5-degree angulation and three patients had 5-10 degree angulation. The most common complication was irritation at nail entry site. Two cases had superficial wound infection at entry site and both healed with oral antibiotics and dressing changes.
Summary: Elastic intramedullary nailing is a safe and reliable treatment method for pediatric tibial fractures. It provides stable fixation and allows rapid healing of fractures with minimal complications.