Functional assessment of diaphyseal femoral fractures in pediatric age group managed by titanium elastic nail system: A prospective study

Background: Femoral shaft fractures are common childhood injuries and are among common causes for hospitalization in children. Treatment varies with child's age. There is little room for question in treatment guidelines in children below the age of 3 years, but in the age group of 4–14 years, it is still a matter of debate. There is a trend toward surgical intervention with the advent of newer surgical techniques. This study aims to evaluate the functional outcome of titanium elastic nail system (TENS) for the treatment of femoral diaphyseal fractures in this age group. Materials and Methods: This study included 63 children between 4 and 14 years of age who sustained femoral diaphyseal fractures and were managed by TENS nailing during the period of the study between April 2017 and April 2020. Results: All patients showed union; there were no cases of nonunion or delayed union or implant failure. Three patients had exposed implant, and 15 developed superficial infections which subsided with antibiotic treatment. Forty-eight patients had excellent Flynn score, and 15 had a satisfactory score. Conclusion: In our series of patients, we concluded that TENS nailing in the study group was easy and reliable. As it is a load-sharing device and does not violate the physis, it allows early mobilization and maintenance of alignment. Other notable advantages include decreased risk of infection and undisturbed fracture hematoma. Superficial infection was one of the commonly observed complications which subsided with oral antibiotics.