A comparative study of functional outcomes of surgical versus conservative management of diaphyseal fractures of tibia in children

Abstract

Introduction: Tibia Shaft Fractures in children are very common. Despite newer innovations in implants and techniques no standardize management stratergy is available. Aims and Objectives: To compare and study time for union, weight bearing and functional outcomes with surgical versus conservative management of diaphyseal fractures of tibia. Materials and methods: We studied 50 patients with tibia shaft fractures treated with Titanium elastic nails and closed reduction cast (CRC). Study was prospective. Radiographic union was defined as bridging of 3 cortices followed by which weight bearing was initiated. Final outcome evaluated at end of 6 months were classified as excellent, satisfactory, poor according to FLYNN criteria. Results: Road traffic accident was common mode of trauma (74%) followed by domestic accident (26%). All patients achieved complete union at mean of 8 weeks (Range 8-12). Majority of patients had angulation less than 50. According to FLYNN criteria, 43 patients had excellent results, 7 had satisfactory results and none had poor result. Conclusion: TENS nailing were superior in displaced fractures of tibia-fibula compared to conservative management in terms of early mobilization, union, weight bearing and residual angular deformity. Larger sample size with longer duration of follow up would give better outcomes.