Appraisal of logicality and safety of intramedullary fixation of paediatric diaphyseal fractures by titanium elastic nails

Background: Since the advent of the flexible intramedullary nailing by the surgeons in Nancy, France 1980, gradually and gradually the conservative treatment of diaphyseal fractures of paediatric long bones is going into oblivion and most of the fractures are now being fixed by titanium elastic nails (TENs), however logics for fixation have never been defined clearly in literature. In this study we appreciated certain features which helped us in appraisal of logicality and safety of intramedullary fixation of paediatric diaphyseal fractures with TENs. Methods: 41 patients between 5-15 years of age with diaphyseal fractures of different long bones were treated by TENs. The patients were followed up for a mean period of 21.6 weeks. Results: All fractures united in a mean time of 8.7 weeks, no serious complications, 2 patients showed limb length discrepancy of <2.0 cm. Mean hospital stay was 6 days, supported weight bearing allowed from 2 nd or 3 rd post-operative day and unsupported within 3-4 weeks, independent toilet use by 15 days, return to school at 2-3 weeks after discharge, parental off-duty only 7-10 days. Conclusions: The intramedullary fixation of paediatric bones with TENs appears quite logical in terms of fracture stability for early mobilisation, early return to school, lesser hospital stay, and lesser parental off-duty. The technique is safe, does not interfere with fracture healing and does not violate the physis as nails are not passed through the physis.