A STUDY OF FUNCTIONAL OUTCOMES OF FLEXIBLE INTRAMEDULLARY NAILING IN PAEDIATRIC FEMORAL SHAFT FRACTURES

Avinash Rastogi*, Arunim Swarup, Abhay Shankar Dube, Sandeep Kumar And Dhruva Raj Chikara

ABSTRACT

Introduction: Flexible intramedullary nail seems advantageous over other surgical methods because it is simple, is a load-sharing internal splint that doesn't violate open physis, allows early mobilization and maintains alignment. This study was planned to assess the efficacy and the functional outcome following flexible intramedullary nailing for shaft femur fracture among the children aged < 15 years. Methods: This prospective study was designed and included 30 patients with simple femoral shaft fractures who were managed by percutaneous stabilisation with two elastic nails in retrograde manner and observations were made regarding the alignment of the fracture, the range of motion of knee and hip, limb length discrepancy, varus and valgus angulation of femur and assessment of result was based on Flynn et al. criterion. Participants were assessed at 3 weeks, 6 weeks, 3 months and 6 months. Results: Total of 20 patients had excellent outcome. There were no poor results. In the present study fracture union time ranged between 6 to 10 weeks and average fracture union time was 7.2 weeks. During six weeks follow up 14% of the children had fracture union and in the remaining (86%) it was noted during 8 weeks follow up. The complications of limb length discrepancy (16.6%), malalignment (0.06%), skin irritation (36.7%), adventitious bursae (0.06%) and joint stiffness in (0.06%) All the patients of the present series were able to squat and sit crosslegged at final follow up. Two cases had knee stiffness till 8months which recovered by 1 year. Conclusion: The present study showed that, flexible intramedullary nailing is an excellent method for the management of femoral shaft fractures in children aged between 5 to 15 years as it results in higher rate of excellent functional outcome with lower incidence of complications. The technique is simple and the hospital stay is less.

Keywords: Intramedullary Nailing; Paediatric; Femoral Shaft; Fractures.