Management of Unstable Tibial Shaft Fracture with Titanium Elastic Nails in Children: Unstable Tibial Shaft Fracture
DOI:
https://doi.org/10.61581/MJSP.VOL02/02/04Keywords:
Elastic Nails, Fracture, Tibia, Titanium, UnstableAbstract
Objectives: to evaluate radiological and functional outcomes of Titanium elastic nails (TEN) in pediatric patients with tibial shaft fractures.
Methodology: Study was prospective design. A total number of forty patients were treated who were presented with tibial shaft fracture. Patients were treated with TEN. In every patient antegrade nailing was performed by inserting a TEN in the medial side of metaphysic and another TEN in the lateral side of the proximal metaphysis. Main outcomes were leg length inequality, union, malunion and complications. SPSS version 23 was used for data analysis.
Result: Functional result (Flynn Criteria) was excellent in 38.5% patients and satisfactory was in 61.5% patients. Patients were treated with TEN. In every patient antegrade nailing was performed by inserting a TEN in the medial side of metaphysic and another TEN in the lateral side of the proximal metaphysis. Main outcomes were leg length inequality, union, malunion and complications. SPSS version 23 was used for data analysis.
Conclusion: Unstable pediatric tibial shaft fractures can be treated ideally through intramedullary fixation technique withtitanium elastic nailing even untreated cases of conservative management and those cannot be reduces due to presence of open wound or edema.
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References
1. Goodbody CM, Lee RJ, Flynn JM. Titanium Elastic Nailing for Pediatric Tibia Fractures: Do Older, Heavier Kids Do Worse? J Pediatr Orthop. 2016 Jul-Aug;36(5):472-7.
2. Stenroos A, Jani, Kosola J. Treatment of Closed Tibia Shaft Fractures in Children: A Systematic Review and Meta-Analysis. European Journal of Pediatric Surgery. 2019;6:487-55.
3. Canavese F, Botnari A, Andreacchio A. Displaced tibial shaft fractures with intact fibula in children: nonoperative management versus operative treatment with elastic stable intramedullary nailing. J Pediatr Orthop 2016;36(07)667-72.
4. Marengo L, Paonessa M, Andreacchio A, Dimeglio A, Potenza A, Canavese F. Displaced tibia shaft fractures in children treated by elastic stable intramedullary nailing: results and complications in children weighing 50 kg (110 lb) or more. Eur J Orthop Surg Traumatol 2016;26(03)311-17.
5. Kinney MC, Nagle D, Bastrom T, Linn MS, Schwartz AK, Pennock AT. Operative versus conservative management of displaced tibial shaft fracture in adolescents. J Pediatr Orthop 2016;36(07)661-66.
6. Messner J, Johnson L, Taylor DM, Harwood P, Britten S, Foster P. Treatment and functional outcomes of complex tibial fractures in children and adolescents using the Ilizarov method. Bone Joint J 2018;100-B(03)396-403.
7. Pennock AT, Bastrom TP, Upasani VV. Elastic intramedullary nailing versus open reduction internal fixation of pediatric tibial shaft fractures. J Pediatr Orthop 2017;37(07)e403-e408.
8. Shore BJ, DiMauro J-PP, Spence DD. , et al. Uniplanar versus Taylor spatial frame external fixation for pediatric diaphyseal tibia fractures: a comparison of cost and complications. J Pediatr Orthop 2016;36(08)821-28.
9. Simon A-L, Apostolou N, Vidal C, Ferrero E, Mazda K, Ilharreborde B. Paediatric tibial shaft fractures treated by open reduction and stabilization with monolateral external fixation. J Child Orthop 2018;12(01)20-28.
10. Shen K, Cai H, Wang Z, Xu Y. Elastic stable intramedullary nailing for severely displaced distal tibial fractures in children. Medicine (Baltimore) 2016;95(39)e4980-e58.
11. Patel NK, Horstman J, Kuester V, Sambandam S, Mounasamy V. Pediatric tibial shaft fractures. Indian J. Orthop. 2018;52:522–28.
12. Berger P, De Graaf J, Leemans R. The use of elastic intramedullary nailing in the stabilisation of paediatric fractures. Injury 2005;36:1217–20.
13. Debnath S, Debbarma S, Sarkar A. Titanium elastic nailing osteosynthesis for diaphyseal tibial fracture in pediatrıc age group-our experience. Indian J. Appl. Res. 2017;7:52–53.
14. Pennock AT, Bastrom TP, Upasani VV. Elastic intramedullary nailing versus open reduction internal fixation of pediatric tibial shaft fractures. J. Pediatr. Orthop. 2017;37:p1.
15. O’Brien T, Weisman DS, Ronchetti P, Piller CP, Maloney M. Flexible Titanium Nailing for the Treatment of the Unstable Pediatric Tibial Fracture. J. Pediatr. Orthop. 2004;24:601–609.
16. Sankar WN, Jones KJ, David Horn B, Wells L. Titanium elastic nails for pediatric tibial shaft fractures. J. Child. Orthop. 2007;1:281–86.
17. Heo J, Oh CW, Park KH, Kim JW, Kim HJ, Lee JC et al. Elastic nailing of tibia shaft fractures in young children up to 10 years of age. Injury 2016;47:832–36.
18. Basaran SH, Erçin E, Çümen H, Da¸sar U, Bilgili MG, Avkan MC. The titanium elastic nailing in pediatric tibia fractures caused pedestrian versus motor vehicle accidents. Bakirkoy Tip Derg. 2016; 12:188–94.
19. Gordon JE, Gregush RV, Schoenecker PL, Dobbs MB, Luhmann SJ. Complications After Titanium Elastic Nailing of Pediatric Tibial Fractures. J. Pediatr. Orthop. 2007;27:442–46.
20. Kc KM, Acharya P, Sigdel A. Titanium elastic nailing system (TENs) for tibia fractures in children: functional outcomes and complications. J. Nepal Med. Assoc. 2016;55:55–60.
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