Closed Tibial Fractures Heal Better With Elastic Nails

Pediatric patients with closed tibial shaft fractures treated with titanium elastic nails are likely to have shorter hospital stays, fewer procedures and a shorter time to union than patients with open fractures, according to study data.

Researchers retrospectively reviewed data for 38 patients treated with titanium elastic nails for tibial fracture fixation to assess the outcomes of both closed and open pediatric tibial fractures. Average follow-up duration was 13 months, and time to union and complications were the study’s primary outcomes.

Patient demographics, closed or open injury and its location, type of open fracture (if applicable), skeletal maturity, hospital length of stay and number of procedures per patient were also evaluated.

Average time to union was longer for open fractures than closed fractures at nine and four months, respectively. This time was significantly longer for type IIIA and IIIB fractures, with average time to union of 11 months for type IIIA and 12 months for IIIB, according to the researchers.

The researchers also found the number of surgical procedures was fewer with closed fractures compared with open fractures — two vs. three, respectively — which led to a shorter mean length of hospital stay among patients with closed fractures vs. open fractures (three days vs. six days).

Complications observed included infection among two patients in the open fracture cohort. One closed fracture (6 percent) and 11 open fractures (52 percent) took longer than six months postoperatively to achieve union.