Evaluation of Pediatric Femur Shaft Fractures Treated with a Titanium Elastic Nailing System (TENS): A Tertiary Level Hospital in Bangladesh

Background: Pediatric femur shaft fractures are common in children, especially in developing countries, and are associated with significant morbidity and mortality. Titanium Elastic Nail System (TENS) has now become the preferred stabilization method in pediatric long bone fractures, particularly femoral shaft fractures. Objective: This study was to evaluation of the Titanium Elastic Nailing System (TENS) for intramedullary fixation of pediatric femoral shaft fractures. Materials and Methods: The study conducted Multicentered based non-randomized prospective study was performed in the Department of Orthopaedic Surgery, Rajshahi Medical College Hospital, Rajshahi, Bangladesh, from January 2021 to December 2022.There was a total of n=40 pediatric patients (5-16 years old; 31 males, 9 girls) who had retrograde TENS fixing for femoral diaphyseal fractures. Gustilo and Anderson's classification criteria were used to classify fractures into Grades I through III. Results: TENS was a safe and effective treatment option for pediatric femur shaft fractures, with all patients achieving fracture healing without major complications. The mean duration of follow-up was 21 months (range 3-39 months). After an average of 9 weeks, the radiographic union was confirmed for all fractures with grade 3 callus development, and by 9.5 weeks, patients may recover full weight bearing. Flynn's criteria evidenced an excellent outcome in 33 patients (82.5 %) and a good outcome in 7 patients (17.5 % Six patients had limb lengthening, four had varus mal-alignment, and three had rotational. In 4 cases, closed reduction failed, and 2 required nail corkscrewing. Conclusion: The study TENS is a reliable treatment option for pediatric femur shaft fractures in a resource-limited setting like Bangladesh. It is a minimally invasive technique that allows early mobilization and reduces the risk of complications associated with traditional treatment methods.