ABSTRACT

Aim: To compare the submuscular locking plate and titanium elastic nail with fracture midshaft of the femur in children in terms of functional and radiological outcomes and complications.

Methods:This randomized controlled trial was performed using a probability simple random sampling technique at the Department of Orthopaedic Surgery, Mayo Hospital Lahore,from January 2014 to December 2016. The sample size was 102 children, ages between 6 to 12year closed midshaft fracture femur were included, and children with midshaft fracture femur previously managed with spica cast, bone malignancy, multiple fractures, osteopenia, osteomalacia or osteomyelitis, and skeletal dystrophy were excluded. They were randomly divided into group A, and group B. Group A was treated with titanium elastic nail, and group B children were treated with the sub-muscular plate. Treatment outcomes for infection, implant failure was assessed clinically, and union and hip function were compared using Hammer et al10 criteria and Flynn 11 criteria, respectively

Results:All of the children had a mean age of 9.05 ± 1.69 years. There were 78(76.5%) male and 24(23.5%) female children. Superficial infection was present in 03 (5.9%) in group A, and no superficial infection was present in group B. No deep infection was observed in group A and 01 (1.9%) deep infection was observed in group-B. There was no case of implant failure. The radiological union in both study groups was statistically the same (p-value > 0.05). The functional outcome at 12th week was significantly better in group-B than group-A, (p-value = 0.031).

Conclusion:The functional outcome was batter with a submuscular plate, while the union was comparable in two groups. Superficial infection was more with titanium elastic nailthan the submuscular plate.

Keywords: Children, femur fracture, internal fixation, submuscular, titanium, union, functional outcome.