Ahmad I, Akhtar M, Qureshi S A, Nadeem A, Chaudhary D I, Nadeem R D, Lal Nasir M Bilal, Taqi M.
Efficacy of Titanium Elastic Intramedullary Nailing System in treatment of Paed Tibial Shaft Fractures.
Pak J Med Health Sci Jan ;15(1):137-40.

Background: Closed reduction and casting is the standard treatment in paediatric tibial shaft fractures. However, in unstable and open fractures surgery may be needed. Aim: To evaluate results after operative fixation in tibial shaft fractures of age group between 6 to 16 years using titanium elastic nails (TENs). Methods: Thirty eight patients, who had unstable tibial shaft fractures, were treated with titanium elastic intramedullary nailing system (TENS) under fluoroscopy in Department of Orthopaedic Unit-1 from January 2019 to September 2020 prospectively. The average age of the patients in our study was 9.2 years (range 6- 12 years). 6(15.79%) out of 38 patients had open fracture that were Grade I in 3 patients, II Grade in one patient and Grade IIIA in two patients. Results: All patients achieved union radiological as well as clinical with a mean of 8.5 weeks. No patient developed Leg length discrepancy. No patient developed angulation in coronal or sagittal plane more than 6 degrees with mean angulation in coronal plane of 4 degrees and sagittal plane 3 degrees. Pin site irritation and infection developed in 9 patients that resolved completely at final follow up. Superficial infection developed in 3 patients who had open fracture and one patient developed deep infection. Conclusion: Intramedullary TENS fixation provides excellent outcome with acceptable complication in Close Unstable and Open tibial fractures in which closed reduction is not possible due to stability, edema or wound. Keywords: Paediatric Tibial Shaft Fracture, titanium elastic intramedullary nailing system (TENS), union

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