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J Clin Orthop Trauma. 2019 Sep-Oct;10(5):922-927. doi: 10.1016/j.jcot.2018.06.010. Epub 2018 Jun 28.

Rust score-An adequate rehabilitation guide for diaphyseal femur fractures managed by TENS.

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Department of Orthopaedics, KGMU, Lucknow, 226018, U.P., India.



The optimal mode of treatment among the wide variety of surgical and nonsurgical treatment options for children between 5 and 15 years of age continues to be controversial. Elastic stable intramedullary nailing of long bone fractures in the skeletally immature has gained widespread popularity because of its clinical effectiveness and low risk of complications.

Methods and methodology:

From Jan 2015 to August 2016, 35 patients including 37 limbs with diaphyseal fractures of the femur in the age group 5-15 years were managed by Titanium Elastic nailing and their clinico-radiological and functional outcome was assessed at 1 year post operatively as per the Flynn's criteria. RUST score was used as a guide for post-operative rehabilitation.


37 patients were managed by TENS nailing including 28 males and 9 females. The outcome in proximal, middle or distal fractures of the shaft were found to be similar and the difference was statistically insignificant. Similarly, the difference in the outcomes as per fracture patterns was also found to be statistically insignificant. Partial weight bearing was allowed after a score of 6 was achieved and full weight bearing after a score of 8.


As per the Flynn's criteria, 75% of the patients (28 out of 37) were found to have an excellent outcome while 7 had a satisfactory outcome and two had a poor outcome. RUST score can be used as an effective guide for post op rehabilitation.


Femur fractures; Flynn’s criteria; RUST score; TENS

[Available on 2020-09-01]

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