Femoral Shaft Fracture Treatment in Patients Age 6 to 16 Years

Stans, Anthony A.; Morrissy, Raymond T.; Renwick, Stephen E.

doi:10.1097/01241398-199903000-00017

Cited by 107 publications

(66 citation statements)

References 22 publications

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“…Only a few authors have addressed the psychological effects of different treatments for children (van Tets and van der Werken 1991, Hughes et al 1995, Stans et al 1999). We do not know the long-term effect of treatment in traction (Hughes et al 1995).…”

Section: Psychological and Social Considerationsmentioning

confidence: 99%

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Surgical treatment of femoral fractures in childrenComparison between external fixation and elastic intramedullary nails: A review

Hedin¹

2004

Acta Orthopaedica Scandinavica

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Section: Psychological and Social Considerationsmentioning

confidence: 99%

“…It has become more common for parents not to want a prolonged treatment time in traction for their children. In many societies, the economic pressure to reduce health care costs also favors treatments that reduce hospitalization time (Newton and Mubarak 1994, Blasier et al 1997, Boman et al 1998, Stans et al 1999.…”

mentioning

confidence: 99%

Surgical treatment of femoral fractures in childrenComparison between external fixation and elastic intramedullary nails: A review

Hedin¹

2004

Acta Orthopaedica Scandinavica

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“…Hospitalization is usually short term and reduces the treatment cost compared to traditional treatments for traction and spica cast (11,12). In addition, psychological recovery is accelerated by early resumption of functional activity, allowing for a rapid return to school and ordinary family life (11)(12)(13)(14). Despite the various advantages of TEn, however, complication rates of up to 60% have been reported, due mostly to incorrect operative techniques and poor patient selection (15)(16)(17)(18)(19)(20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

Pitfalls of femoral Titanium Elastic Nailing

et al. 2014

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Background and Aims: Despite several potential complications of elastic intramedullary nailing, it is currently the treatment of choice for femoral diaphyseal fractures in schoolaged children. this study aimed to critically evaluate the complications of titanium elastic nailing in pediatric femoral shaft fractures.Material and Methods: this study evaluated patients with a diaphyseal femoral fracture treated with titanium elastic nailing (ten) in tampere university Hospital in finland. the study group included 32 children with a mean age of 9 years during a 5-year period, from 1 January 2003 to 31 December 2007. Data were collected from medical records and x-rays. mean follow-up time was 42 months.Results: of 32 patients, 9 (28%) reported a postoperative complication. complications were associated with nail prominence in five (16%) patients and instability in four (12%) patients. in patients with nail prominence, the titanium elastic nailing-nail ends were unbent and 10-35 mm outside the cortex of the distal femur. the nail prominence caused pain and delayed knee mobilization until the nail was removed after a mean time of 4 months. in patients with fracture instability, the mean titanium elastic nailing-nail/ medullary canal diameter ratio was 46% and periosteal callus formation was 5.4 mm at the first control. in those with stable fractures, the values were 66% and 9.2 mm, respectively.Conclusions: based on this study, two types of pitfalls in a small volume center were found. titanium elastic nail ends were left unbent and too long. We recommend palpating the nail ends to exclude nail prominence and to verify free movement of the knee after nail cutting and bending. fracture instability was caused by inserting titanium elastic

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“…The choice of treatment remains still challenging to the orthopaedic surgeons due to high rate of complications like, malunion, joint stiffness, limb length discrepancy, late functional recovery and psychological problems in children [8] . To avoid the effects of prolonged hospitalisation, operative treatment is gaining popularity.…”

Section: Discussionmentioning

confidence: 99%

Our experience of titanium elastic nailing for paediatric diaphyseal femoral fractures in a series of 25 cases

S¹

2018

Int. J. Orthop. Sci.

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Pediatric femoral diaphyseal fractures are still managed conservatively by many surgeons, due to rapid healing and remodelling of the deformities. They are often associated with various complications. The fractures of shaft femur ain children are treated with various types of traction for about three weeks by cast. There are two major drawbacks, one is prolonged bed rest which separates child from his routine activity which in turn adds to more cost of hospitalisation. But with the advent of Elastic stable Intramedullary Nailing [ESIN], such fractures can be treated with surgical treatment to minimise all the disadvantages. The closed surgical treatment of these fractures allows early weight bearing and walking which facilitates early bridging callus and rapid restoration of bone continuity. Keywords: Pediatric femur fractures, titanium elastic nails IntroductionFemoral shaft fractures are among the most common major pediatric injuries, treated by orthopaedic surgeons. Various methods of treatment available for femoral shaft fractures in children. In the last 20 yrs there has been trend towards the operative treatment for middle aged children between 6-15 years [9] .The main aim of femoral shaft fractures fixation is to attain early mobilisation which in turn encourages restoration of the movements. This will hastens psychological recovery for the patient. There are a wide variety of surgical and nonsurgical treatment options available like spica cast, traction followed by casting, external fixation, plate fixation, intramedullary nails and flexible intramedullary nails. In the last few decades operative stabilization of femoral shaft fractures has gained popularity due to problems of non -operative treatment options. All these problems have been addressed by ESIN. This was introduced for femoral shaft fractures by Nancy group in 1979. ESIN are flexible nails that allow adequate bending and avoid the need to cross the physis during insertion. ESIN requires relatively small incision and easy hardware removal. ESIN technique causes minimal soft-tissue trauma, quick recovery and shorter hospital stay. ESIN are load sharing implants which maintains reduction for few weeks till callus formation with minimal blood loss. The elasticity of nail promotes callus formation by reducing stress. The titanium implants also has excellent biocompatibility. In the last ten years the Enders nails and titanium elastic nails have been used widely. With this our focus of study is mainly on use of ESIN in respect with closed procedure, minimal blood loss, less hospitalisation, safe procedure which allows early return to the homely environment for the children.

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Femoral Shaft Fracture Treatment in Patients Age 6 to 16 Years

Cited by 107 publications

References 22 publications

Surgical treatment of femoral fractures in childrenComparison between external fixation and elastic intramedullary nails: A review

Surgical treatment of femoral fractures in childrenComparison between external fixation and elastic intramedullary nails: A review

Pitfalls of femoral Titanium Elastic Nailing

Our experience of titanium elastic nailing for paediatric diaphyseal femoral fractures in a series of 25 cases

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