Sanjiv Kumar1, Tushar Anand2, Sudhir Singh3. 1. Assistant Professor, Department of Orthopaedics, Era,s Lucknow Medical College & Hospital , Lucknow, UP, India . 2. Junior Resident, Department of Orthopaedics, Era,s Lucknow Medical College & Hospital , Lucknow, UP, India . 3. Professor & Head, Department of Orthopaedics, Era,s Lucknow Medical College & Hospital , Lucknow, UP, India .
Abstract
BACKGROUND: Fracture shaft femur is common paediatric trauma leading to significant morbidity. Conservative treatments available are associated with prolonged periods of immobilization. Use of flexible intramedullary implant allows early rehabilitation in diaphyseal fractures of femur in children. AIM: The aim of the present study is to compare fixation of diaphyseal femur fracture by titanium elastic nail and intramedullary K-wires in children. SETTING AND DESIGN: Prospective randomized study in a tertiary care hospital. MATERIAL AND METHODS:Fifty-two children between 6 years and 14 years of age with femoral shaft fracture were assigned either in Group I or Group II based on computer generated random numbers. In Group I closed percutaneous intramedullary K- wire fixation and in Group II closed percutaneous intramedullary titanium elastic nail was used to fix the fractures. Partial weight bearing was allowed after 6 weeks of surgery and full weight bearing at clinico-radiological union. RESULTS:Average time of radiological union was 6 to 10 weeks in both groups. In both the groups two cases had entry site irritation which resolved with early implant removal. One case in both the groups had unacceptable mal-alignment. Both the groups had few cases of limb-length discrepancy, which was in acceptable limit, except two cases of TENS. There was no statistically significant difference between the results of both the groups. But, using K-wires significantly reduced the cost of treatment. CONCLUSION: Most of such fractures in our society are neglected because of high cost of treatment. Providing a cheaper alternative in form of K-wires may be beneficial for the patients from low socio-economic status.
RCT Entities:
BACKGROUND:Fracture shaft femur is common paediatric trauma leading to significant morbidity. Conservative treatments available are associated with prolonged periods of immobilization. Use of flexible intramedullary implant allows early rehabilitation in diaphyseal fractures of femur in children. AIM: The aim of the present study is to compare fixation of diaphyseal femur fracture by titanium elastic nail and intramedullary K-wires in children. SETTING AND DESIGN: Prospective randomized study in a tertiary care hospital. MATERIAL AND METHODS: Fifty-two children between 6 years and 14 years of age with femoral shaft fracture were assigned either in Group I or Group II based on computer generated random numbers. In Group I closed percutaneous intramedullary K- wire fixation and in Group II closed percutaneous intramedullary titanium elastic nail was used to fix the fractures. Partial weight bearing was allowed after 6 weeks of surgery and full weight bearing at clinico-radiological union. RESULTS: Average time of radiological union was 6 to 10 weeks in both groups. In both the groups two cases had entry site irritation which resolved with early implant removal. One case in both the groups had unacceptable mal-alignment. Both the groups had few cases of limb-length discrepancy, which was in acceptable limit, except two cases of TENS. There was no statistically significant difference between the results of both the groups. But, using K-wires significantly reduced the cost of treatment. CONCLUSION: Most of such fractures in our society are neglected because of high cost of treatment. Providing a cheaper alternative in form of K-wires may be beneficial for the patients from low socio-economic status.
Entities:
Keywords:
Diaphyseal fractures; Femur; K-wire; TENS nail
Authors: John M Flynn; Lael M Luedtke; Theodore J Ganley; Judy Dawson; Richard S Davidson; John P Dormans; Malcolm L Ecker; John R Gregg; B David Horn; Denis S Drummond Journal: J Bone Joint Surg Am Date: 2004-04 Impact factor: 5.284