A Comparative Study of Management of Femoral Shaft Fracture in Children
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Abstract
Context: Fracture of the shaft of the femur is one of the major pediatrics trauma resulting in a life-long disability. There are many treatment options available including early application of Spica cast, external surgical fixation, intramedullary nailing or conservative treatment that involves immobilization for a prolonged period of time, mostly in a hospital setup.
Aim: The aim of this study is to examine the consequences and functional outcomes of the fractures of femoral shaft in pediatric department which were treated with intramedullary internal fixation (using K-wire and Titanium elastic nail) as the potential of malunion is greater in elastic nails specially if weight is heavier and it allows full weight bearing without cast .
Study Design and Method: A prospective study conducted at the Department of Orthopedic, Specialist Orthopedic, Al Qassimi Hospital Sharjah EHS United Arab Emirates from February 2019 to January 2020. Total of 80 children were evaluated for this study with age between 4-11 years having unstable in close reduction of femoral shaft. Each participant was followed up for 12 months to check unions, malunions, delayed unions, or nonunions and excellent, good, and poor outcomes
Results: On statistical analysis of the outcome of the treatment and prognosis of the results based on Flynn et al criteria 72.5% had excellent outcome scores in Group A treated with titanium nails) and 70% in Group B (treated with stainless steal K wires. On general statistical analysis, both the groups showed similar rates in post-operative complications.
Conclusion: The two groups showed similar results in terms of union, partial full weight bearing activities after the intramedullary nailing intervention was evaluated. However, stainless steel Kirschner wire has certain advantages over titanium elastic nail making it a slightly better option which include: cost effectiveness, easy availability, lesser pre-operative hospital stay and lesser surgical waiting time.