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European Orthopaedics and Traumatology

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01-09-2015 | Original Article

Titanium elastic nailing for noncomminuted femoral fractures in older adolescents and young adults: a prospective comparative study versus interlocking nailing

Author: Yasser Assaghir

Published in: European Orthopaedics and Traumatology | Issue 3/2015

Abstract

Objective

There are no reports of using titanium elastic nail (TEN) over 18 years. This article studies using TEN in young adults and tries to define its usefulness and safety compared to the standard treatment with interlocking nailing (IN).

Design

A prospective comparative study.

Setting

This study was conducted in a level-1 trauma center.

Patients and methods

Thirty-one fractures in 30 patients with a mean age of 19.1 (17–21) years were treated with TEN compared to 32 fractures in 31 patients with a mean age of 19.0 (17–21) treated with IN with 2 years minimum follow-up.

Outcomes

Outcomes included union, malunion, return of activities, hospital stay, operative time, postoperative pain, radiation, and cost.

Results

IN was biologically better (with no statistical significance) than TEN: union (11.7 ± .2.4 versus 10.8 ± 2.1 weeks), coronal angular deformity (CAD) (1.2 ± 1.7° versus 0.4 ± 1.3°), shortening (0.9 ± 1.3 mm versus 0.4 ± 1.2 mm), sagittal angular deformity (SAD) (0.9 ± 1.4° versus 0.5 ± 1.6°), or rotational deformity (RD) (1.3 ± 1.2° versus 0.5 ± 1.4°). IN was functionally better: earlier full weight-bearing (2.9 ± 1.9 versus 11.7 ± .2.1 weeks, P = .000) and earlier return of activity (15.9 ± 2.4 versus 17.3 ± 2.8 weeks, P = .003). TEN had shorter operative time (54.8 ± .9 versus 62.5.0 ± 16.0 min with P = .024), postoperative pain (P = .001), and cost by 22.6 % (P = .001). Four of TEN group had painful nail end, and two had calcar penetration. Heterotopic ossifications occurred in four cases (IN). Mean follow-up was 29.6 months (TEN) and 30.1 (IN). We had no length discrepancy, nonunion, refractures, infection, or deaths.

Conclusion

TEN is inferior to IN functionally, close to it biologically, superior to it as to cost, postoperative pain, and surgical time, and can be considered a safe option in this age group.

Level of evidence

Therapeutic level II.

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Title: Titanium elastic nailing for noncomminuted femoral fractures in older adolescents and young adults: a prospective comparative study versus interlocking nailing
Author: Yasser Assaghir
Publication date: 01-09-2015
Publisher: Springer Berlin Heidelberg
Published in: European Orthopaedics and Traumatology / Issue 3/2015
Print ISSN: 1867-4569
Electronic ISSN: 1867-4577
DOI: https://doi.org/10.1007/s12570-015-0301-7

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Titanium elastic nailing for noncomminuted femoral fractures in older adolescents and young adults: a prospective comparative study versus interlocking nailing

Abstract

Objective

Design

Setting

Patients and methods

Outcomes

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objective

Design

Setting

Patients and methods

Outcomes

Results

Conclusion

Level of evidence

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