ABSTRACT

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