FUNCTIONAL OUTCOME OF TITANIUM ELASTIC NAILING IN THE TREATMENT OF FEMORAL SHAFT FRACTURES AMONG CHILDREN LESS THAN 8 YEAR

BACKGROUND: Femoral shaft fractures are one of the most common in young children which often necessitate operative stabilization to warrant proper alignment and early mobilization. Titanium elastic nailing has gained acceptance in pediatric orthopedics due to its minimally invasive nature and ability to provide stable fixation. This method provides the benefit of rapid fracture healing and reduced complication rates. OBJECTIVE: To determine the functional outcome of Titanium Elastic Nailing in the treatment of femoral shaft fractures among children under 8 years of age. METHODOLOGY: This descriptive study was conducted on 128 children aged 01-07 years with femoral shaft fractures from 25-May-2025—25-November-2025 at department of orthopaedic surgery of Lady Reading Hospital, Peshawar. All the patients underwent surgical fixation with titanium elastic nails. Functional outcomes were assessed at 12th week using Flynn's criteria and categorised as excellent, good, fair, and poor. Functional outcomes were stratified with time to surgery, malunion, limb length deficiency (LLD), infection, and nail irritation using chi square test, P value ≤ 0.05 was considered significant. RESULTS: Mean age of the 128 patients was 4.98±1.46 years. Male patients were 84 (65.6%). Functional outcomes were excellent in 65.6% (n = 84) cases and good in 22.7% (n = 29). A statistically significant association was found between shorter time to surgery and excellent outcomes (p < 0.001). Early weight bearing was associated with excellent outcomes (p < 0.001). All patients with a poor outcome had malunion (p < 0.001) and infection (p < 0.001). LLD (>2 cm) was associated with poor outcomes (p < 0.001). CONCLUSION: Titanium elastic nailing demonstrated excellent and good functional outcomes in majority of the children. Excellent functional outcomes were significantly associated with early surgical intervention, early post-operative weight bearing, and the absence of complications such as malunion, infection, and limb length discrepancy.