Complications Associated With Retained Implants After Plate Fixation of the Pediatric Forearm

Vopat, Bryan G.; Kane, Patrick M.; Fitzgibbons, Peter G.; Got, Christopher; Katarincic, Julia A.

doi:10.1097/01.bot.0000435630.63770.3d

Cited by 19 publications

(41 citation statements)

References 26 publications

(35 reference statements)

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“…Vopat et al published similar data in which the refracture rate was 7.1% in patients with retained plates. 35 From their retrospective review, they concluded that retaining plates in pediatric forearm fractures did not increase the refracture rate compared to removal from historical rates in the literature.…”

Section: Operative Fixation With Platesmentioning

confidence: 98%

Treatment of diaphyseal forearm fractures in children

2014

Orthop Rev

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Both bone forearm fractures are common orthopedic injuries. Optimal treatment is dictated not only by fracture characteristics but also patient age. In the pediatric population, acceptable alignment can tolerate greater fracture displacement due to the bone’s ability to remodel with remaining growth. Generally, these fractures can be successfully managed with closed reduction and casting, however operative fixation may also be required. The optimal method of fixation has not been clearly established. Currently, the most common operative interventions are open reduction with plate fixation versus closed or open reduction with intramedullary fixation. Plating has advantages of being more familiar to many surgeons, being theoretically superior in the ability to restore radial bow, and providing the possibility of hardware retention. Recently, intramedullary nailing has been gaining popularity due to decreased soft tissue dissection; however, a second operation is needed for hardware removal generally 6 months after the index procedure. Current literature has not established the superiority of one surgical method over the other. The goal of this manuscript is to review the current literature on the treatment of pediatric forearm fractures and provide clinical recommendations for optimal treatment, focusing specifically on children ages 3-10 years old.

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Section: Operative Fixation With Platesmentioning

confidence: 98%

Treatment of diaphyseal forearm fractures in children

2014

Orthop Rev

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“…17 On the other hand plate fixation has disadvantages like excessive surgical dissection, neurovascular injury, hardware irritation, another major surgery of equal magnitude for implant removal, refracture after plate removal, peri-prosthetic fractures if plate not removed. 16,[18][19][20] Various studies have shown that IM nailing can provide acceptable fracture reduction, stabilization for fracture healing, results in minimal cosmetic deformity, and facilitates easy removal of implants after treatment. 21,22 It does not disturb the periosteal blood supply and fracture hematoma.…”

Section: Resultsmentioning

confidence: 99%

Functional outcome of diaphyseal fractures of forearm in adolescents treated with TENS

et al. 2019

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Background: A retrospective case series study was done on forearm diaphyseal fracture in adolescents treated with TENS (titanium elastic nailing system). Purpose of the study was analysis of functional outcome of TENS in forearm diaphyseal fractures in children between 12-18 year age group.Methods: We retrospectively evaluated 30 patients operated by same senior surgeon during the period from March 2014 to February 2015 with closed diaphyseal forearm fractures in age group 12–18 years treated with TENS in whom closed reduction could not be achieved. Nail diameter taken as 33-40% of narrowest diameter of diaphysys were introduced proximally in ulna and distally in radius under image intensifier in closed manner. Postoperatively, patients encouraged for active shoulder, elbow and finger movements and suture removal done after 2 weeks. Patients were followed up for minimum period of one year. Results: In terms of union and range of motion using Anderson et al criteria 24 patients had excellent results, 4 patients had satisfactory results and one patient had poor result having non-union of ulna. Two patients had superficial infection at the nail entry site which eventually resolved. One patient lost for follow up.Conclusions: We conclude that TENS in both bone forearm fractures in adolescent age group in terms of union and range of motion is a minimally invasive and effective method of fixation.

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“…), and female pediatric patients having worse outcomes after plate implant to repair displaced forearm fracture (Vopat et al. ). Cardiac devices have also been a focus of concern, with evidence that women are less likely than men to benefit from some implantable cardiac devices and more likely to have complications (Dhruva and Redberg ).…”

Section: Gender and Medical Implant Failuresmentioning

confidence: 99%

“…This finding was not expected at the time, but resonates with more general concerns about the safety and effectiveness of medical devices for women patients. A number of studies have found gender differences associated with orthopedic implants, including women having higher sensitivity to the metals found in joint replacements (Caicedo et al 2017), and female pediatric patients having worse outcomes after plate implant to repair displaced forearm fracture (Vopat et al 2014). Cardiac devices have also been a focus of concern, with evidence that women are less likely than men to benefit from some implantable cardiac devices and more likely to have complications (Dhruva and Redberg 2012).…”

Section: Gender and Medical Implant Failuresmentioning

confidence: 99%

Gender Bias in Medical Implant Design and Use: A Type of Moral Aggregation Problem?

Hutchison¹

2019

Hypatia

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In this article, I describe how gender bias can affect the design, testing, clinical trials, regulatory approval, and clinical use of implantable devices. I argue that bad outcomes experienced by women patients are a cumulative consequence of small biases and inattention at various points of the design, testing, and regulatory process. However, specific instances of inattention and bias can be difficult to identify, and risks are difficult to predict. This means that even if systematic gender bias in implant design is an ethical issue, it is one with no clearly blameworthy player. From a practical perspective, there is no single obvious point at which to intervene. Philosophers working in other areas have explored structurally similar moral problems—sometimes referred to as “moral aggregation problems”—such as the type of environmental harm caused by small actions of many players. I describe key features of these type of problems and strategies to address them. I then draw on these to suggest an approach to gender bias in medical implant design and use.

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Complications Associated With Retained Implants After Plate Fixation of the Pediatric Forearm

Abstract: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Cited by 19 publications

References 26 publications

Treatment of diaphyseal forearm fractures in children

Treatment of diaphyseal forearm fractures in children

Functional outcome of diaphyseal fractures of forearm in adolescents treated with TENS

Gender Bias in Medical Implant Design and Use: A Type of Moral Aggregation Problem?

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