Comparison Of Effect Between Titanium Elastic Nail And Locking Compression Plate In The Treatment Of Femoral Shaft Fracture In Children

ObjectiveComparison of clinical effect between titanium elastic nails and locking compression plate in the treatment of the femoral shaft fracture in children, sum up experience.Materials and methodsThis study retrospectively analysed 34 patients with femoral shaft fractures treated in Bethune clinical hospital of Jilin university from October 2006 to December 2010. There were19 male cases, female 15cases;They had an average age of 7.21years. In these cases,19 cases suffered from traffic accidents; 10 cases had self-fallen,3 cases had fallen from a height,2 cases were caused by the heavy thing. Based on AO classification,11 cases belonged to class A,16 cases belonged to class B,7 cases belonged to class C.9 cases were the upper femoral shaft fractures,the middle 17 cases, the lower 8 cases. All of the cases were closed fresh fractures without injuries of important blood vessels and never. Preoperative time was 3 hours to 4 days after fracture. According to the treatment:the treatment group of titanium elastic nails(group A) had 16 cases and the treatment group of the locking compression plate(group B) had 18 cases. The evaluated indexes included operation time,surgical bleeding,fracture healing time,postoperative inflection,malunion,internal fixation loosening or fracture,knee joint dysfunction and so on.ResultAll of the 34 cases were followed up for 3～12 months, the average time was 8 months. The 16 cases in group A were no nonunion, the average healing time is 2.13 months. Nail tail irritation happened to one of them, the sign had disappeared after removing the nails. The injured leg had overgrown for 1～3mm, the average overgrowth was 2.12mm. Efficacy evaluation:excellent in 14 cases, good in 2 cases. Clinical evaluation of knee function: excellent in 15 cases, good in 1 case. There was no delayed union or postoperative inflection. The 18 cases in group B were all bony union, the average healing time is 2.39 months. Screw loosening happened to one of them, the case was bony union trough plaster adjuvant therapy. The injured leg had overgrown for 2～5mm, the average overgrowth was3.15mm. Efficacy evaluation:excellent in 16 cases, good in 2 cases. Clinical evaluation of knee function:excellent in 17 cases, good in 1 case. There was no delayed union or postoperative inflection.ConclusionThrough the comparison of the methods between titanium elastic nails and locking compression plate fixation in the treatment of the femoral shaft fracture in children, we can obtain the advantages of the titanium elastic nails :minimal invasion, little stress shielding, no interference with the epiphysis or blood circulation, convenience of pulling out nails. TEN is fit to treat transverse fracture, short oblique fracture, short spiral fracture of the femoral shaft fractures in children; TEN is an simple and effective treatment method. While for multiple unstable fracture, near joint fracture, with injuries of important blood vessels and never; the locking compression plate fixation is an sensible therapeutic approach.