Effectiveness of osteosynthesis with flexible titanium rods in the long-term treatment of femoral fractures in children aged 0 to 7 years

Background. In recent years, in the treatment of hip fractures in pediatric practice, there has been a tendency to move from conservative methods using a plaster cast and traction to surgical stabilization.

Aim. To evaluate the results of treatment of femoral fractures by osteosynthesis with flexible titanium rods in children aged 0 to 7 years in the long-term period.

Materials and methods. The study included 118 children aged 0–7 years with femoral fractures. Average age – 3.3±1.8 years, 74 (62.7%) boys, 44 (37.3%) girls. In the main group (n=62), surgical treatment was performed, mainly with the help of osteosynthesis with flexible titanium rods – ESIN (n=56; 90.3%). The reference group (n=56) underwent conservative treatment of fractures.

Results. In the main group, accelerated fracture consolidation was noted in 74.2%, in the reference group – 32.1% of cases (p=0.032). With the use of conservative treatment, half of the patients had delayed consolidation of fractures, after surgical treatment there were only 5 such cases (8.1%, p=0.005). The overall frequency of long-term complications after fracture treatment (contracture and deformity of adjacent joints) in the main group was 8.1%, in the reference group it was 23.2% (p<0.05). In the main group, 51.6% of patients had no movement restrictions in adjacent joints (in the reference group – 19.6%, p=0.012) and 64.5% had no change in limb length (in the reference group – 17.9%, p=0.025). In the main group, 88.7% of the children's relatives rated the result of treatment as “excellent” and “good”, in the reference group 83.9% of the ratings were satisfactory and unsatisfactory.

Conclusion. Long-term results of treatment of femoral fractures in children aged 0–7 years using ESIN are better, and satisfaction with treatment of relatives of children is higher than with conservative methods.