A comparative study of titanium elastic nailing versus hip spica in treatment of femoral shaft fractures in children

Magesh Babu Palanisamy, Dhanpal Singh, Manikanda Rajan A and Balamurugavel P S

Background: There is no consensus on treatment of closed femoral-shaft fractures in children. We compared hip spica cast with titanium elastic nailing (TEN) in the treatment of femoral shaft fractures in children.
Materials and Methods: Study was conducted at Rajah Muthiah Medical College and Hospital, Chidambaram, Tamilnadu, India. Out of 30 paediatric patients of diaphyseal fracture femur in the age group of 4 -16 years, 12 were treated conservatively by spica cast and 18 were treated with TEN. Follow up done regularly up to twelve months of injury with taking into account, various parameters.
Results: All diaphyseal fractures of femur healed, whether treated conservatively by spica cast or treated operatively with TEN. The time of union and weight bearing was less in operative group as comparative to spica cast group. 2 patients (16.6 %) in spica group compared to none in operative group had malunion while 2 patients in the operative group had soft tissue irritation.
Conclusions: Results of TEN turned out to be far superior to traction and spica cast treatment in paediatric femoral fractures. Rate of complications was far low with operative than conservative Treatment.

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