Outcome and Comparison of Conservative, Ten Nail And Enders Nail Fixation in Management of Shaft of Lower Limb Bones Fracures in Children Of 5- 14 Years Age

AIM: 1.To evaluate the long term results of internal fixation of paediatric femoral shaft fractures and tibial shaft fractureswith flexible intramedullary nailing. 2. To compare the results of flexible nail internal fixation with conservative management (closed reduction and spica cast /Long leg cast).. MATERIALS AND METHODS: 250 patients including 193 femoral shaft fractures and 57 tibial shaft fractures were operated with closed TEN  nails  fixation. 150 patients including 105 femoral and 45 tibialfractures were oprerated with enders nails. The results were compared with another group of 100 patients including 60 femoral shaft fractures and 40 tibial shaft fractures treated with conservative method of closed reduction and casting. All patients were 5 to 14 years old. RESULTS: According to Flynn criteria, Group I -TEN nail fixation: Excellent results = 163 cases (65.2%) Satisfactory results = 87 cases (34.8%) Poor result = 0 Group II Enders  nail fixation : Excellent results = 100 cases (66.6%) Satisfactory results = 50 cases (33.4%) Poor result = 0. Group III Conservative method: Excellent results = 60 patients (60%) Satisfactory results = 36 patients (36%) Poor result = 4 patients (4%). CONCLUSION: To correct angulation in diaphyseal fractures in childhood, intramedullary nailing with flexible nails is an easy and safe method. avoiding the prolonged immobilization and complications of traction and spica casting.