Vol. 9 No. 3 (2026), Original Article
Vol. 9 No. 3 (2026)
Original Article

Outcome Comparison Between Titanium Elastic Nailing and Hip Spica Casting in Pediatric Femoral Shaft Fractures
Open Access
Open Access

Mohd Mohidul Islam
Assistant Professor, Department of Orthopedic Surgery, National Institute of Traumatology and Orthopaedic Rehabilitation, Dhaka, Bangladesh
https://orcid.org/0009-0007-0263-6319 (unauthenticated)
K M Shorfuddin
Assistant Professor, Department of Orthopedic Surgery, National Institute of Traumatology and Orthopaedic Rehabilitation, Dhaka, Bangladesh
Rizwan Jamil
Assistant Professor, Department of Orthopedic Surgery, National Institute of Traumatology and Orthopaedic Rehabilitation, Dhaka, Bangladesh
S M Tanveer Rahman
Assistant Professor, Department of Orthopedic Surgery, National Institute of Traumatology and Orthopaedic Rehabilitation, Dhaka, Bangladesh
Zakaria Bin Hamid
Assistant Professor, Department of Orthopedic Surgery, National Institute of Traumatology and Orthopaedic Rehabilitation, Dhaka, Bangladesh
Saiful Islam
Assistant Surgeon, Department of Ilizarov and Deformity Correction, National Institute of Traumatology and Orthopaedic Rehabilitation, Dhaka, Bangladesh
Nahidul Islam
Medical Officer, Narsingdi 100 Bed Zilla Hospital, Narsingdi, Bangladesh
Published 23-08-2026

DOI: 10.5281/zenodo.22070593


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Keywords

Titanium elastic nailing
Hip spica casting
Pediatric femoral shaft fracture
Functional outcome

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Outcome Comparison Between Titanium Elastic Nailing and Hip Spica Casting in Pediatric Femoral Shaft Fractures. The Insight [Internet]. 2026 Aug. 23 [cited 2026 Sep. 26];9(3):636-41. Available from: https://bdjournals.org/insight/article/view/1414
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Abstract

Background: Femoral shaft fractures are one of the most frequent fractures that require hospitalization in children, and the best treatment for school-age children is still a topic of debate between operative fixation using titanium elastic nailing (TEN) and conservative treatment using hip spica casting. This study aimed to compare the functional outcome results of TEN with hip spica casting in children with femoral shaft fractures. Methods & Materials: This comparative study was conducted at from Department of Orthopedic Surgery, National Institute of Traumatology and Orthopaedic Rehabilitation, Dhaka, Bangladesh July 2025 to December 2025 and comprised 60 children with femoral shaft fractures, who were equally divided into two groups: TEN group (n=30) and hip spica casting group (n=30). Demographic, injury, treatment, radiological, and functional variables were recorded and compared between the two groups. Data were entered and analyzed on SPSS version 26. Results: Both groups showed similar outcomes at baseline. The time to partial and full weight-bearing, return to school, and radiological union was shorter in the TEN group than in the hip spica group, while the hospital stay was longer in the TEN group. The overall treatment-related complications (16.7% vs. 40%) and residual deformity were lower in the TEN group, and the final functional outcome and return to normal activity by 12 weeks were better with TEN. Conclusion: The results of this study indicate that titanium elastic nailing showed better outcomes than hip spica casting in children with femoral shaft fractures in terms of functional recovery and complication rate, and should be considered as the treatment of choice in the appropriate patient population in school-age children.
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