Treatment of paediatric tibial shaft fracture with titanium elastic nails

Background: Conservative treatment by closed reduction and cast application is the gold standard treatment for tibial shaft fracture in children. Surgical intervention is required in tibial shaft fractures associated with multiple long bone fracture, head injury, unstable tibial fracture, compound tibial fracture, failed closed reduction and cases of compartment syndrome. Titanium elastic nails (TENS) are the ideal implant for paediatric tibial fractures as it maintains alignment and rotation without causing damage to open physis. Method: The present study was conducted in Department of Orthopaedics GMC Jammu on 25 patients presenting with tibial fractures. Paediatric tibial fractures were fixed with two titanium elastic nails through proximal tibia preserving the physis. Results: Twenty five patients were treated with TENS. There were 14 male and 11 female. Commonest mode of injury pattern is road traffic accident. Nail prominence and skin irritation is the commonest complication encountered in 4(16%) patients, delayed union 2(8%), malunion1(4%) and infection at entry portal 1(4%) patient. Evaluation of the results were done were by Flynn criteria. In 17 (68%) patients excellent results were seen, 8 (32%) patients satisfactory results were seen and poor result was not seen in any patient. Conclusion: Titanium elastic nail achieve satisfactory results in management of paediatric tibial fractures in which surgery is indicated. TENS is the treatment of choice in children with compound fractures or soft tissue injuries as it allows rapid healing of tibial fracture with minimal complications.