Venkataraman Sagar, Ethiraj Prabhu, Shanthappa Arun H, Vellingiri Kishore
Department of Orthopaedics, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, IND.
Cureus. 2022 Sep 8;14(9):e28924. doi: 10.7759/cureus.28924. eCollection 2022 Sep.
Diaphyseal femur fractures are commonly seen in the paediatric age group as there is an increase in the incidence of road traffic accidents. Titanium elastic nailing system (TENS) and plating are the common methods used for paediatric long bone fracture fixation. The purpose of our study was to evaluate and compare functional and radiological outcomes of paediatric femur diaphyseal fractures treated with locking compression plates and with TENS.
Our study included 59 patients diagnosed with femur shaft fracture. Twenty-eight patients included in group one underwent open reduction and internal fixation with locking compression plates and 31 patients in group two underwent open reduction/closed reduction with intramedullary TENS. All post-operation patients were evaluated at four, eight, 10, 12, 16, 20, 24, and 36 weeks. The functional outcome was assessed based on the Flynn scoring system and radiological union based on fracture union on X-ray.
We analyzed our data using the Flynn scoring system. In group one, out of 28 cases treated with locking compression plates, 25 (89%) were excellent, two (7.5%) were satisfactory, and one (3.5%) was poor. In group two, out of 31 cases treated with intramedullary TENS, 26 (83.8%) were excellent and five (16.2%) were satisfactory. In our study, the average union time in group one was 11.4 weeks and in group two was 14.41 weeks. Fracture union was 100% in both groups.
In our study, we noted that the union of the femur shaft was early with the use of locking compression plates. In TENS, there was less intraoperative blood loss, very minimal postoperative scar, and less soft tissue damage. Also, implant removal was easier compared to locking compression plates.
由于道路交通事故发生率上升，小儿股骨干骨折在儿科年龄组中较为常见。钛弹性髓内钉系统（TENS）和钢板内固定是小儿长骨骨折固定常用的方法。本研究的目的是评估和比较锁定加压钢板与TENS治疗小儿股骨干骨折的功能和影像学结果。
本研究纳入59例诊断为股骨干骨折的患者。第一组28例患者接受锁定加压钢板切开复位内固定，第二组31例患者接受髓内TENS切开复位/闭合复位。所有术后患者在术后4、8、10、12、16、20、24和36周进行评估。功能结果根据弗林评分系统进行评估，影像学愈合根据X线骨折愈合情况进行评估。
我们使用弗林评分系统分析数据。在第一组28例接受锁定加压钢板治疗的病例中，25例（89%）为优，2例（7.5%）为良，1例（3.5%）为差。在第二组31例接受髓内TENS治疗的病例中，26例（83.8%）为优，5例（16.2%）为良。在我们的研究中，第一组的平均愈合时间为11.4周，第二组为14.41周。两组骨折愈合率均为100%。
在我们的研究中，我们注意到使用锁定加压钢板时股骨干愈合较早。在TENS治疗中，术中出血量较少，术后瘢痕非常小，软组织损伤较少。此外，与锁定加压钢板相比，植入物取出更容易。
