American Journal of Public Health Research
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American Journal of Public Health Research. 2015, 3(4A), 65-68
DOI: 10.12691/ajphr-3-4A-14
Open AccessResearch Article

Outcome of Diaphyseal Fracture of Tibia Treated with Flexible Intramedullary Nailing in Pediatrics Age Group; A Prospective Study

P R Onta1, , P Thapa1, K Sapkota1, N Ranjeet1, A Kishore1 and M Gupta1

1Department of Orthopedics, Manipal Teaching Hospital, Pokhara, Nepal

Pub. Date: June 15, 2015
(This article belongs to the Special Issue Maternal and Child Health)

Cite this paper:
P R Onta, P Thapa, K Sapkota, N Ranjeet, A Kishore and M Gupta. Outcome of Diaphyseal Fracture of Tibia Treated with Flexible Intramedullary Nailing in Pediatrics Age Group; A Prospective Study. American Journal of Public Health Research. 2015; 3(4A):65-68. doi: 10.12691/ajphr-3-4A-14

Abstract

Fracture of Tibia is the most common amongst pediatric fractures. Most tibial shaft fractures are treated conservatively with close reduction and above knee cast application. Surgery is indicated only when the fracture is unstable, open fracture and associated with multiple injuries. Flexible intramedullary nailing is commonly used for diaphyseal tibial fracture and is also well used in other long bone fracture. The advantages of flexible intramedullary nailing are minimal invasive surgery, short hospital stay and early weight bearing. The objective of this prospective study was to review the functional outcome of flexible intramedullary nailing in pediatric age group. In the study, the union time, weight bearing time and complications associated with flexible intramedullary nailing were observed. There were 18 children with fracture shaft of tibia treated at the Department of Orthopedics, Manipal Teaching Hospital, Pokhara, Nepal from April 2014 to March 2015. The protocol consisted in flexible intramedullary nailing of fracture shaft of tibia in children. Angulation, shortening and other complications were checked. In our study the average age of the patient was 8.2 years (range 6–12 years). Out of 18 children with fracture shaft of tibia 15 had close fracture and 3 had open fracture. All fracture cases treated with flexible intramedullary nailing had good alignment post operatively. The average age of the patient was 8.2 years (range 6-12 years). Sixteen children had an angulation of less than 5 degrees and 2 children had angulation of 5 to 10 degrees which was acceptable to the age group. The mean time of radiological union was 13.3 weeks with early callus formation of 4.3 weeks. The average time for full weight bearing was 8.8 weeks. The average hospital stay of the patient was 5.7 days (range from 3 to 16 days). Fixation with flexible intramedullary nails in diaphyseal fracture shaft of tibia in pediatric age group is simple, effective, minimally invasive procedure with short hospital stay and having good outcome.

Keywords:
Fracture Tibia Flexible Intramedullary Nailing Pediatrics Group

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  Santili C, Gomes C, Waisberg G, Braga S, Lino JW, Santos FG. Tibialdiaphyseal fractures in children. ActaOrtop Bras 2010; 18: 44-48.
 
[2]  Stephen DH, James FM. In: editor. Fractures of the shaft of the tibia and fibula, diaphyseal fracture of tibia and fibula, treatment (chapter 25). Rockwood &Willkin’s fractures in children. 6th ed. Lippincott Williams & Wilkins; 2006. 1045-1046.
 
[3]  Canale ST, Beaty JH, editors. Fractures and dislocations in children, tibial and fibular fractures (chapter 33). Campbell’s operative orthopaedics. 11th ed. 2008.
 
[4]  Yusof NM, Oh CW, Oh JK et al. Percutaneous plating in paediatrictibial fractures. Injury 2009; 40: 1286-1291.
 
[5]  Wessel L, Seyfriedt CS, Hock S, Waag KL. [Pediatric tibial fractures: is conservative therapy still currently appropriate?] (ingerman). Unfallchirurg 1997; 100: 8-12.
 
[6]  Metaizeau J. Stable elastic intramedullary nailing of fractures of the femur in children. J Bone Joint Surg Br 2004; 86: 954-957.
 
[7]  Ligier JN, Metaizeau JP, Prevot J, Lascombes P. Elastic stable intramedullary pinning of long bone fractures in children. Z Kinderchir 1985; 40: 209-212.
 
[8]  Goodwin RC, Gaynor T, Mahar A, Oka R, Lalonde FD. Intramedullary flexible nail fixation of unstable pediatric tibialdiaphyseal fractures. J PediatrOrthop 2005; 25: 570-576.
 
[9]  Sathian B, Sreedharan J, Baboo NS, Sharan K, Abhilash ES, Rajesh E. Relevance of Sample Size Determination in Medical Research. Nepal Journal of Epidemiology 2010; 1 (1):4-10.
 
[10]  Galano GJ, Vitale MA, Kessler MW et al. The most frequent traumatic orthopaedic injuries from a national pediatric inpatient population. J PediatrOrthop 2005; 25: 39-44.
 
[11]  Yang JP, Letts RM. Isolated fractures of the tibia with intact fibula in children: a review of 95 patients. J Pediatr Orthop 1997; 17: 347-351.
 
[12]  Tolo VT. External skeletal fixation in children’s fractures. J PediatrOrthop 1983; 3: 435-442.
 
[13]  Kubiak EN, Egol KA, Scher D, et al. Operative treatment of tibial fractures in children: are elastic stable intramedullary nails an improvement over external fixation? J Bone Joint Surg [Am] 2005; 87-A: 1761-8.
 
[14]  Liu P, Wei Z, Wei Y X, et al. Treatment of children’s shaft fracture of tibia and fibula with ESIN fixation. OJPed 2011; 1: 9-11.
 
[15]  O’Brien T, Weisman DS, Ronchetti P, Piller CP, Maloney M. Flexible titanium nailing for the treatment of the unstable paediatrictibial fracture. J PediatrOrthop 2004; 24: 601-609.
 
[16]  Qidawi SA. Intramedullary Kirschner wiring for tibia fractures in children. J PediatrOrthop 2001; 21: 294-297.
 
[17]  Wiss D, Segal D, Gumbs VL, Salter D. Flexible nailing of tibial shaft fractures. J Trauma 1986; 62 12:1106-12.
 
[18]  Vallamshetla P, De Silva U, Bache CE, Gibbons PJ. Flexible intramedullary nails for unstable fractures of the tibia in children. An eight-year experience. J Bone Joint Surg Br 2006; 88: 536-540.
 
[19]  El-Adl G, Mostafa MF, Khalil MA, Enan A. Titanium elastic nail fixation for paediatric femoral and tibial fractures. Acta Orthop Belg 2009; 75: 512-520.
 
[20]  Ahmed E K.F, Zakaria B, Hadhood M, ShaheenA. Management of diaphysealtibial fracture in pediatric by elastic stable intramedullary nails. Menoufia Med J 2014; 27: 401-406.
 
[21]  Gordon JE, Gregush RV, Schoenecker PL et al. Complications after titanium elastic nailing of pediatric tibial fractures. J Pediatr Orthop 2007; 27: 442-446.
 
[22]  Sommer C, Gautier E, Mu¨ller M, Helfet DL, Wagner M. First clinical results of the locking compression plate (LCP). Injury 2003; 34 (Suppl 2): 43-54.