title: Results of titanium elastic nailing in paediatric femoral diaphyseal fractures----report of 30 cases.
abstract: OBJECTIVE
  Fractures of the femur are the most incapacitating fractures. For children aged 6-14 years, there is no clear consensus as to the preferred treatment. The conventional treatment of traction and casting is no longer recommended. We report our experience in titanium elastic nailing for treatment of paediatric femoral diaphyseal fractures.
  
  
  METHODS
  Thirty patients in the age group of 6-16 years with displaced diaphyseal femoral fractures were stabilized with titanium elastic nails. Patients were followed up clinically and radiologically for a minimum period of 1 year. The final results were evaluated using Flynn's criteria. Technical difficulties and complications associated with the procedure were also analysed.
  
  
  RESULTS
  Overall results were excellent in 20 cases and satisfactory in 10 cases. No patient had poor result. The average hospital stay was 9 days. All the fractures healed with an average time to union of 6.86 weeks. The most common complication encountered was soft tissue irritation at the nail entry site seen in 6 cases. Clinically, lengthening was noticed in 4 cases, while no patient had shortening. Malalignment was seen in only 6 cases. Perioperative difficulties encountered were failure of closed reduction seen in 6 cases and corkscrewing of nails in one case.
  
  
  CONCLUSIONS
  Titanium elastic nails are a relatively easy to use, minimally invasive, physeal-protective implant system with high rate of good and excellent outcomes in children aged 6-16 years. Technical pitfalls can be eliminated by adhering to the basic principles.
authors.affiliation: All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Divesh
authors.initials: D
authors.lastname: Jalan
authors.forename: Rajesh
authors.initials: R
authors.lastname: Chandra
authors.forename: V-K
authors.initials: VK
authors.lastname: Sharma
mesh_terms: D000293:Adolescent; D001858:Bone Nails; D002648:Child; D004548:Elasticity; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D017102:Fracture Healing; D006801:Humans; D007902:Length of Stay; D008297:Male; D011446:Prospective Studies; D014025:Titanium
chemical_list: D014025:Titanium