Osteossíntese das fraturas diafisárias da criança com hastes intramedulares flexíveis

Volpon, José Batista

doi:10.1590/s0102-36162008000700001

Cited by 6 publications

(11 citation statements)

References 31 publications

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“…1 Although fractures of the bones of the forearm are successfully treated conservatively, outcomes remain variable, and, subsequently, some cases may require additional fracture manipulation or formal surgical intervention due to residual angulations. 2 3 4 5 6 Previous studies have shown that the failure of nonoperative treatment of midshaft fractures in pediatric populations ranges between 39 and 64%. 3 Alternatives include closed remanipulation and casting, pins and plaster, closed or mini-open reduction, intramedullary (IM) nailing, and open reduction and internal fixation (ORIF) with plates and screws.…”

Section: Introductionmentioning

confidence: 99%

“…1 Embora as fraturas dos ossos do antebraço sejam tratadas com sucesso de forma conservadora, os resultados permanecem variáveis e, posteriormente, alguns casos podem exigir manipulação adicional da fratura ou intervenção cirúrgica formal devido a angulações residuais. 2 3 4 5 6 Estudos anteriores mostraram que a falha do tratamento não cirúrgico das fraturas mediodiafisárias em populações pediátricas varia entre 39 e 64%. 3 As alternativas incluem remanipulação fechada e imobilização, pinos e gesso, redução fechada ou miniaberta com haste intramedular (IM) e redução aberta com fixação interna (RAFI) usando placas e parafusos.…”

Section: Introductionunclassified

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Fixação intramedular flexível para fraturas diafisárias dos ossos do antebraço em crianças

et al. 2019

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Objectives Most of the fractures of the bones of the forearm in children are successfully treated conservatively with closed reduction and casting. The outcomes remain variable and the patients may require additional fracture manipulation or formal surgical intervention due to residual angulations. The present study assesses the radiological and functional outcomes of treating displaced forearm fractures in children with intramedullary flexible titanium elastic nailing. Methods A total of 31 patients aged between 7 and 15 years old with displaced forearm fractures underwent flexible titanium elastic nailing. The patients were followed-up for a mean period of 8.51 months (range: 6–12 months) and were assessed for radiological and functional outcomes. The Price criteria were used to assess the functional outcome. Results Out of 31 patients, 21 patients underwent closed reduction, and 10 required a minimal opening of the fracture site during reduction. A total of 29 patients had excellent results with normal forearm and elbow range of motion (ROM), and 2 patients had good results. In all patients, good radiological union was seen at an average time of 7.9 weeks. Five patients had minor complications, such as skin irritation over the prominent ulnar nail ( n = 2), superficial nail insertion site infection ( n = 2), and backing out of the ulnar nail ( n = 1), requiring early removal. Conclusion Flexible nailing is an efficient application of internal fixation for shaft fractures of both bones of the forearm in children, enabling early mobilization and return to the normal activities of the patients, with low and manageable complications.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionunclassified

Fixação intramedular flexível para fraturas diafisárias dos ossos do antebraço em crianças

et al. 2019

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“…Volpon, 33 in 2008, recommended that diaphyseal fractures of forearm bones in children be fixed, when necessary, with titanium rods. According to him, these fractures are among those that most benefit from surgical treatment.…”

Section: Literature Datamentioning

confidence: 99%

Fraturas na criança: Estamos ficando mais cirúrgicos?

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Pontes

2022

Rev Bras Ortop (Sao Paulo)

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ResumoHistoricamente, as cirurgias no esqueleto imaturo eram reservadas às fraturas expostas ou articulares. Nos últimos anos, a melhora na qualidade e segurança das anestesias, novos equipamentos de imagem, implantes desenhados especialmente para fraturas pediátricas, associados à possibilidade de menor tempo de hospitalização e rápido retorno ao convívio social vêm demonstrando uma nova tendência de avaliar e tratar fraturas na criança. O objetivo deste artigo de atualização é responder às seguintes questões: (1) estamos realmente ficando mais cirúrgicos na abordagem das fraturas em crianças? (2) Caso isto seja verdadeiro, esta conduta cirúrgica está baseada em evidências científicas? De fato, nas últimas décadas, a literatura médica demonstra artigos que suportam melhor evolução das fraturas na criança com o tratamento cirúrgico. Nos membros superiores, isto fica muito evidente na sistematização da redução e fixação percutânea das fraturas supracondilianas do úmero e das fraturas de ossos do antebraço. Nos membros inferiores, o mesmo ocorre com fraturas diafisárias do fêmur e tíbia. No entanto, há lacunas na literatura. Os estudos publicados são geralmente com baixa evidência científica. Assim, pode-se deduzir que, mesmo sendo a abordagem cirúrgica mais presente, o tratamento de fraturas pediátricas deve ser sempre individualizado e conduzido de acordo com o conhecimento e experiência do médico profissional, levando em conta a presença de recursos tecnológicos disponíveis para o atendimento do pequeno paciente. Deve-se incluir todas as possibilidades, não cirúrgicas e/ou cirúrgicas, sempre instituindo ações baseadas na ciência e em concordância com os anseios da família.

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“…Therefore, conservative treatment is now reserved for infants, and surgical fixation is predominantly used for older children and adolescents. 3 …”

Section: Introductionmentioning

confidence: 99%

“…The stabilization of diaphyseal fractures of the femur with a flexible intramedullary nail (FIN) inserted percutaneously decreases morbidity, provides stability, and does not disrupt callus formation. 3 The method is effective, quick, and easyly performed, with minimal complications to treat diaphyseal fractures of the immature femur. 4 Therefore, currently, FIN is used for treating patients older than 4 years of age or, even younger, when comorbidities are present such as obesity, spasticity, or poor bone quality.…”

Section: Introductionmentioning

confidence: 99%

Flexible Intramedullary Nails in Pediatric Subtrochanteric Femur Fracture: Biomechanical Study

2023

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Objective Evaluate the stability provided by two flexible intramedullary nails (FINs) in a simulation of fractures at the proximal levels in pediatric femur models. Methods Two FINs were inserted in 18 synthetic models of pediatric femurs. Fractures were simulated at one of three levels, and the models were divided into the following groups (n=6): diaphysis (control), subtrochanteric and trochanteric. Flex-compression tests were performed with force up to 85 N. Relative stiffness and the average deformation was obtained. Torsion tests were performed by rotating the proximal fragment until 20°, to obtain the average torque. Results At flex-compression, the set’s average relative stiffness and average deformations were: 54.360x103 N/m and 1.645 mm in the control group, respectively. In the subtrochanteric group, the relative stiffness was 31.415x103 N/m (-42.2%) and the deformation was 2.424 mm (+47.3%) (p<0.05). For the trochanteric group, the relative stiffness was 30.912x103 N/m (+43.1%) and the deformation was 2.508 mm (+52.4%) (p<0.05). In torsion, the average torque was 1.410 Nm in the control group; 1.116 Nm in the subtrochanteric group (-20.8%), and 2.194 Nm in the trochanteric group (+55.6%) (p<0.05). Conclusion FINs do not seem to be biomechanically competent for the treatment of proximal femoral fractures. Level of Evidence I; Therapeutic Studies - Investigating the results of treatment.

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Osteossíntese das fraturas diafisárias da criança com hastes intramedulares flexíveis

Cited by 6 publications

References 31 publications

Fixação intramedular flexível para fraturas diafisárias dos ossos do antebraço em crianças

Fixação intramedular flexível para fraturas diafisárias dos ossos do antebraço em crianças

Fraturas na criança: Estamos ficando mais cirúrgicos?

Flexible Intramedullary Nails in Pediatric Subtrochanteric Femur Fracture: Biomechanical Study

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