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Abstract
Background:
Pediatric tibial diaphyseal fractures are common long bone injuries, often managed either conservatively with casting or operatively with Titanium Elastic Nailing System. This study aimed to compare the clinical and radiological outcomes of TENS versus conservative management in children.
Methods:
This prospective observational study was conducted in the Department of Orthopaedic Surgery, Jinnah Postgraduate Medical Centre (JPMC), Karachi from August 2024 to February 2025. A total of 82 children aged 5–11 years with tibial diaphyseal fractures were enrolled, with 41 managed by the TENS and 41 by conservative casting. Patients were followed at scheduled intervals until radiological union was confirmed. Time to partial and full weight bearing along with duration of hospital stay and complication rates were noted.
Results:
Excellent and acceptable functional outcomes were significantly more frequent with TENS (53.7% vs. 24.4%, p = 0.022; and 97.6% vs. 75.6%, p = 0.004, respectively). The TENS group demonstrated earlier mobilization, with shorter mean time to partial (2.85 ±0.76 vs. 5.94 ±1.13 weeks, p <0.001) and full weight bearing (8.05 ±1.35 vs. 11.88 ±1.93 weeks, p <0.001). Hospital stay was longer in the TENS group (4.07 ±0.96 vs. 2.07 ±0.91 days, p <0.001). Delayed union occurred more frequently in the conservative group (p =0.007), while rates of malunion, infection, limb-length discrepancy, and re-fracture were comparable between groups.
Conclusion:
TENS demonstrated superior outcomes in terms of earlier mobilization and reduced incidence of delayed union compared to conservative management, though at the cost of a slightly longer hospital stay.