Comparison of Dynamic Compression Plate Versus Titanium Elastic Nailing System in the Management of Pediatric Femoral Diaphyseal Fractures

Abstract

Objective: To compare the clinical outcomes of Dynamic Compression plate (DCP) versus Titanium Elastic Nailing System (TENS) in the surgical management of pediatric femoral diaphyseal fractures in a tertiary care hospital in Pakistan.
Study Design: Prospective non-randomized comparative study.
Place and Duration of Study: Imran Idrees teaching hospital Sialkot, 8 months.
Materials and Methods: This prospective non-randomized comparative study was conducted at Imran Idrees Teaching Hospital, Sialkot from April–December 2023. A total of 60 children (aged 7–12 years) with isolated femoral shaft fractures were enrolled and divided into DCP (n=30) and TENS (n=30) groups. Outcomes measured included fracture union time, operative duration, and postoperative complications. Statistical analysis was performed using SPSS v26, with p value <0.05 taken as significant.
Results: The mean time for fracture union was substantially lower in DCP group. (11.53 ± 0.571 weeks) compared to the TENS group (14.10 ± 2.524 weeks, p=0.001). Conversely, TENS showed a significantly lower operative time (30.83 ± 0.986 minutes) than DCP (53.20 ± 1.243 minutes, p=0.001). A moderate inverse correlation was found between BMI and fracture union time in the TENS group (ρ = -0.455, p=0.013).
Conclusion: Both DCP and TENS are effective surgical options for pediatric femoral shaft fractures. DCP enables faster fracture healing, while TENS reduces operative time. Treatment decisions should be individualized based on patient profile and surgical context.