Our Ender Nailing Applications in Pediatric Tibial Shaft Fractures

Abstract

Aim: Although tibial shaft fractures in children are mostly treated conservatively. Surgical treatment should be considered in patients in school age with the tibial shaft fracture or with multiple long-bone fracture or who have organ injury. The patients treated their tibia shaft fractures with Ender nail are presented in this article. Material ans Method: Two tibia Ender nails been 3.5 mm in appropriate length were performed under general anesthesia to the 13 fractures of 12 patients, all of whom were children and 9 out of whom were men. Long-leg splint was used for 2 weeks after the surgery. The patients were allowed to go to school after 10 days. Patients were evaluated according to Flynn criteria in terms of the clinical outcome and infection with their follow-up X-rays and examination and the type of the fracture, duration of the union, shortening-length difference, rotation, limitation of the joint motion, refracture. Results: The mean age of the patients was 8,6 years (4-15). The type of the fracture was Winquist type 2 and 3 in all of the patients. The mean duration of the follow-up was 20 months (14-40). Two of the existing-open fractures were type 1 and one of them was type 2 in three patients. In the difference of the length and shortening in treated tibias in patients was an average of 7 mm (2-21), the difference of the rotation was 4 degrees (2-8), and the angulation of varus-valgus was an average of 5 degrees (2-10). None of the patients developed refractures. A perfect result in 5 fractures, a good result in 7 fractures and a bad result in 1 fracture were taken according to the criteria of Flynn. Discussion: Ender nail should first be considered in the surgical treatment of the tibial shaft fractures in children over the age 4 because of the early return to school, low of the refracture risk after the detection and the price advantage.