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Background: Fractures of the femoral shaft are common childhood injuries and among the most common causes of hospitalization for pediatric orthopedic injuries. The treatment for femoral shaft fractures varies based on the child's age and injury with a trend towards operative stabilization. With newer techniques like Titanium Elastic Nailing (TEN) has given good results of fracture reduction and reduced the time of immobilization over previous methods like hip spica cast, external fixators and enders nailing. Objectives: to review the experience of clinical recovery in treatment of pediatric shaft femur fracture with titanium elastic nailing. Methodology: after taking institutional ethics committee patients were enrolled according to inclusion and exclusion criteria. Then the patients were treated by minimally invasive osteosynthesis by titanium elastic nailing. Patients were followed up on third, sixth and twelfth week after the surgery and tenderness at insertion site, range of movement of knee, range of movement of hip, squatting, cross legged sitting, limb length discrepancy, radiological investigation were assessed. Flynn’s criteria were used to assess the results. Observation: common type of fracture were transverse (41.5%) and spiral (39%) fracture. And at 12 weeks only 2 (4.9%) patients had the significant tenderness, 4 (9.8%) of patients had limb length discrepancy of 1 to 2 cms, and 41 (100%) radiological union was seen in (100%) patients. The final outcome according to Flynn’s criteria shows that excellent outcome seen in 35 (85.3%) of patients, while 4 (9.8%) patients showed satisfactory outcome. Conclusion: Titanium elastic nail seems advantageous over other surgical methods particularly in this age group because it is simple, is a load shearing device, internal splint that doesn’t violate open physis, allows early mobilization and maintains alignment. Micromotion conferred by the elasticity of the fixation promotes faster external bridging callus formation. The periostium is not disturbed and being a closed procedure there is no disturbance of fracture hematoma, thereby less risk of infection.

Functional outcome of treatment of paediatric diaphysial femur fractures operated using titanium elastic nailing