Abstract

Background: Femur fractures are one of the most prevalent injuries in children. Femoral shaft fractures are the most common orthopedic injury that requires hospitalization, accounting for around 1.6 percent of all bone injuries in children. Treatment for femoral shaft fractures in children is determined by the patient's age and weight, as well as the type of fracture. Traction and hip Spica were the usual treatments for all femoral shaft fractures that needed a lengthy stay in the hospital until recently. However, in recent decades there has been a shift toward increased use of surgery such as intramedullary nailing and plate fixation because of decrease impairment, increase convenience and decrease cost of care. There are increasing reports in literature that operative treatment more satisfactory results than non-operative but the treatment of choice in children are still controversial.

Aims and Objective: To compare the functional outcome in patients who underwent surgery for the femoral shaft fracture using the titanium elastic nail and the plate fixation.

Methods: This is prospective and comparative study was carried out in the department of orthopedic surgery, unit IV and V Taihe Hospital affiliated to Hubei University of Medicine, Shiyan, Hubei, China from April 2018 to February 2019. A total of 20 patients were enrolled in this study and divided equally into 2 groups TENS and plate 10 patients on each group.

Results: Out of 20 patients10 (50%) patients treated with TENS and 10 (50%) were treated with plates. Mean age of total patients was 6.65 ± 2.110 years. road traffic accident is the main cause of injury in both group which comprises 5 (50%) patients in TENS group and 4 (40%) patients in plate group. Majority of the factures were in the middle third of the femoral shaft. The mean blood loss in TENS group was 16 ± 6.146 ml while in plates group 160 ± 45.947 ml. which shows significant between two groups with (p = 0.00 < 0.005). The average operating time in TENS group was found to be 54 ± 14.298 minute while in case of plaiting group was 127 ± 22.998 minute with (p = 0.000 < 0.05). Average time of union in TENS group was 8.10 ± 2.846 weeks and in plate group was 9.80 ± 1.989 weeks. Which is insignificant with (p = 0.139 > 0.05). among total 17 (85%) patients had no complications, Superficial infection found in 2 (10%) patients with plates group. and delayed union was found in 1 (5%) patient in with TENS group with (p = 0.217 > 0.05). There is no significance difference found with respect to complication between both groups. The final outcome assessed by Flynn’s criteria, showed that 14 {7 (70%) were from TENS group and 7 (70%) from plate group} had excellent results. 6{3 (30%) from TENS group 3 (30%) from plate group} had satisfactory and None of them have poor result in both group. These differences were not found to be statistically significant (p = 1.000 > 0.05).

Keywords: Titanium Elastic Nail; Plate Fixation; Pediatric Femur Fracture; Femoral Shaft Fracture

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Citation

Citation: Bikash Neupane., et al. “TENS Versus Plate Fixation in treatment of Pediatric Femoral Shaft Fracture. A Randomised Control Trial Study". Acta Scientific Orthopaedics 5.5 (2022): 34-40.

Copyright

Copyright: © 2022 Bikash Neupane., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.