Diaphyseal Fractures of Femur in Children: Functional Outcome of Intramedullary Fixation with Titanium Elastic Nails

Aim: The main objective of this study was to evaluate the functional outcome of intramedullary fixation with titanium elastic nails in diaphyseal fractures of femur in children. Study Design: Prospective/Observational Study. Place and Duration: This study was conducted at the Department of Orthopedics, Quaid-e-Azam Medical College/BV Hospital/Civil Hospital Bahawalpur, Pakistan from March, 2018 to February, 2020. Methods: In this study total 36 patients of both genders presenting with diaphyseal femur fractures were included. Patients' ages were ranging from 04 to 15 years. After taking written consent from parents/guardians, detailed demographics including age, sex, and mode of injury, side and type of fractures were recorded. Nail size was decided per-operatively according to Flynn's Formula (Nail Diameter=80% of Cavity diameter/02. Post-operative Back-slab was applied for 03 to 04 weeks. Patients were discharged on second post-operative day and followed up at 02 weeks, 06 weeks, 12 weeks and 24 weeks after surgery. Data was analyzed by SPSS 20.0. Results: Out of 36 patients, 27 (75%) were males while 09 (25%) were females. Majority 24 (66.67%) patients were ages <10 years. RTA was the most common mode of injury in 16 (44.44%) patients followed by fall in 14 (38.89%) patients. Mean time to bone union was 3.62 +/- 1.44 months. At final follow-up, 26 (72.22%) patients had excellent 06 (16.67%) had good, 03 (8.33%) patients had fair and 01 (2.78%) patient had poor functional outcomes. Conclusion: Titanium elastic nails is a simple, safe, minimal invasive technique in children with diaphyseal fracture of femur with fewer complications.