Complications of ESIN osteosynthesis—Experience in 270 patients

Bukvić, Nado; Marinović, Marin; Bakota, Bore; Veršić, Ana Bosak; Karlo, Robert; Kvesić, Ante; Gusić, Nadomir; Čoklo, Miran; Bukvić, Frane

doi:10.1016/j.injury.2015.10.042

Cited by 10 publications

(4 citation statements)

References 23 publications

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“…Most complications occur due to inadequate indication or poorly performed surgical technique. 20 In this study, the Kapandji technique was used to fix the radius in all patients and the ulna fixation was performed by retrograde or anterograde intramedullary route, with no inherent complications identified surgical technique. Factors associated with loss of reduction are considered to be low technical quality in the making of plastered immobilization, associated fracture of the ulna, and initial angular greater than 30°.…”

Section: Discussionmentioning

confidence: 99%

Does Ulna Fixation Alter the Outcome for Distal-Third Forearm Fractures in Children?

Neto¹,

SANTOS²,

BEZERRA³

et al. 2022

Acta ortop. bras.

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Introduction Fractures of the distal third of the forearm are common in the pediatric population. Conservative treatment of an ipsilateral fracture of the distal ulna metaphysis is one of the risk factors for loss of reduction. Percutaneous fixation of the fracture with K-wires is recommended. This study aims to evaluate the outcome of percutaneous fixation of both bones performed as the primary treatment. Materials and Methods A randomized, open, prospective, clinical trial was conducted, including skeletally immature patients who underwent surgery for fractures of the distal radius and ulna. They were randomized into two groups, one with fixation only of the radius fracture and the other with fixation of both the radius and the ulna fractures, and they were followed clinically and radiologically for up to 12 weeks postoperatively. Results Sixteen children were selected. In the intraoperative period, fluoroscopy was activated for a longer time when fixing the ulna (p = 0.011) and the surgical time was longer in this group (p = 0.014). In the postoperative evaluations, the group whose surgery involved the fixation of both bones had a lower postoperative pain score (p <0.001) and less time away from school (p <0.001). Conclusions In this study, postoperative pain and absence from school were both less when fixation of the radius and ulna was performed. Evidence Level II; Randomized Controlled Study.

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Section: Discussionmentioning

confidence: 99%

Does Ulna Fixation Alter the Outcome for Distal-Third Forearm Fractures in Children?

Neto¹,

SANTOS²,

BEZERRA³

et al. 2022

Acta ortop. bras.

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“…It was seen that the angulation decreased in time. We thought that this complication can be decreased by surgical experience, appropriate technique, and careful follow-up 17,18…”

Section: Discussionmentioning

confidence: 99%

Titanium elastic nailing in pediatric femoral diaphyseal fractures in the age group of 6-15 years mid-term and long-term outcomes

Kayaokay¹,

Aktuğlu²

2018

Pak J Med Sci

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Objective:To evaluate the effectiveness of Titanium Elastic Nailing (TEN) used in the surgical treatment of pediatric femoral shaft fractures and the effect of the complications to the outcome. Another objective was to assess the changing of Limb Length Discrepancy (LLD) and angulation degree with prolonged follow-up time and to evaluate whether the patient had a functional problem because of this situation.Methods:Thirty children between the ages of 6 and 15 who had femur shaft fractures were evaluated. The times of operation, ambulation, bone union and follow-up were recorded. Post-operative complications were evaluated between 1996-2016 with at least 24 Months follow up.Results:The mean follow-up was 52.5 ± 49.0 months (range 24-240). The mean varus angulation was 3.2 ± 5.1 degrees. The length of the fracture side was approximately 0.71 ± 0.58 cm (range 0-2.09 cm) longer than the intact side. There were eight patients with LLD of 1-2 cm. There was no statistically significant relationship between the type, location, and age of fracture of the LLD (P> 0.05). It was evaluated according to Flynn’s criteria. According to this, 12 (40%) of the patients’ results were excellent, 14 (46.7%) were good, and four were poor.Conclusion:TEN is an effective, easy, fast treatment method and has minimal complications for the treatment of femoral shaft fractures in childhood. Most complications can be reduced by performing basic principles and technical directions. Although LLD is a common complication of childhood femur fractures, the disease does not present a functional problem in daily life.

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“…Incorrect insertion points or malpositions of the entry holes can jeopardize the physeal plates, the sensory branch of the radial nerve, or the tendons, which are also potential complications of the classic ESIN method. [ 24 – 27 ] Advantages of our technique are the early mobilization with a short splint and the elimination of potential growth plate injury. We think that our technique is a minimally invasive, easily learnable alternative operative method, when compared to percutaneous pinning in metaphyseal, and plate or transepiphyseal osteosynthesis in cases of diametaphyseal-displaced fractures of the forearm of radius.…”

Section: Discussionmentioning

confidence: 99%

Short, double elastic nailing of severely displaced distal pediatric radial fractures

Varga

Józsa²,

Fadgyas³

et al. 2017

Medicine

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Rationale:Short double elastic nailing is a minimal invasive, modified ESIN (elastic stable intramedullary nailing) technique for severely displaced distal radial fracture in children. The aim of this technical report is to introduce our new method and evaluate the final results of the procedure.Patient concerns:We reviewed retrospectively 24 patients who underwent short double elastic nailing due to distal radial fractures between November 2012 and December 2015. Indications for surgery included closed, severely displaced, unstable metaphyseal or diametaphyseal fractures of the radius.Intervention:The fractures were stabilized by 2 prebent short elastic titanium nails inserted from the distal side of the fracture. In cases of associated ulnar fracture, a classic anterograd ESIN nailing was also performed. Patients were mobilized immediately in a removable short splint which was removed after 1 to 2 weeks. There has been no additional splinting or casting.Outcomes:There were 17 males and 7 females with an average age of 9.8 years (range, 4–16 years). The right hand was involved in 16 cases and the left hand in 8 cases. The average follow-up was 17.8 months (range, 7–28 months). Of the 24 patients, 3 presented irritation of the skin, which resolved after removal of the radial nail. All the patients regained full range of motion without any complications.Lessons:Our technique is an effective, safe, and easily learnable procedure for unstable fractures of the distal third of the radius. It achieves good functional and radiological results, and allows early mobilization without the need of casting. Avoiding the physeal plates, we reduce the risk of iatrogenic postoperative deformity. Further prospective and biomechanical investigations are necessary to verify our experience.

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Complications of ESIN osteosynthesis—Experience in 270 patients

Cited by 10 publications

References 23 publications

Does Ulna Fixation Alter the Outcome for Distal-Third Forearm Fractures in Children?

Does Ulna Fixation Alter the Outcome for Distal-Third Forearm Fractures in Children?

Titanium elastic nailing in pediatric femoral diaphyseal fractures in the age group of 6-15 years mid-term and long-term outcomes

Short, double elastic nailing of severely displaced distal pediatric radial fractures

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