Femoral Shaft Fractures in Children: Traction and Casting versus Elastic Stable Intramedullary Nailing

Buechsenschuetz, Karl E.; Mehlman, Charles T.; Shaw, Kevin J; Crawford, Alvin H.; Immerman, Elisa B.

doi:10.1097/00005373-200211000-00017

Cited by 128 publications

(101 citation statements)

References 26 publications

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“…There will be scars with all surgical procedures, even with pin traction (Buechsenschuetz et al 2002). With EF, the scars will be on the lateral side of the thigh and with ESIN they will be on both sides of the knee, and a little further.…”

Section: Complicationsmentioning

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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Section: Complicationsmentioning

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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“…Although immediate hip spica casting is still commonly recommended in children between 1 and 6 years of age, [11] operative treatment has become increasingly common in older children [12]. Many authors have raised awareness of the possible social, economic, educational, and emotional costs of prolonged immobilization [13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Intramedullary Kirschner wire (K-wire) fixation of femoral fracture in children

Jawadi

Abdul-Samad

2007

Journal of Children's Orthopaedics

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Purpose The aim of this study was to evaluate the efficacy of standard intramedullary Kirschner wires (K-wires) for the treatment of femoral shaft fracture in children. Methods We report the results of intramedullary K-wires nailing in 178 children with a mean age of 7.7 years (range, 4-14 years) from 2000 to 2005, retrospectively. A total of 184 diaphyseal femoral fractures were treated with both antegrade and retrograde nailing using the same principles of elastic stable intramedullary nailing (ESIN). The patients were followed for 12 months on average (range, 6-24 months).Results No major complication (limb length discrepancy [15 mm, non-union, avascular necrosis, knee joint stiffness) occurred during the observation period. All fractures healed within 7.1 weeks on average (range, 5-12 weeks). Associated injuries were seen in 16.9% of the cases. All but seven fractures were reduced by closed manipulation. Early mobilization and weight bearing was allowed. Intramedullary K-wires were removed after an average of 4.8 months (range, 3-12 months) without any complications. Conclusions In children, intramedullary fixation by using standard K-wires provides effective treatment for the diaphyseal femoral fracture that has excellent clinical results. Each intramedullary K-wire costs US $5, which adds a cost effective advantage to this method of treatment.

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“…One such study emphasized that titanium elastic nail is superior in terms of union, scar acceptance, and overall patient satisfaction compared to traction and casting. 12 Similarly, another study documented good functional outcomes in 79 femoral fractures managed with flexible intramedullary nails. 16 The transverse fracture was the most common type of fracture pattern seen in our study as well as in the other previous study.…”

Section: -13mentioning

confidence: 93%

Flexible intramedullary nails: the panacea for paediatric femoral shaft fractures

et al. 2017

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Background: Management of pediatric femoral shaft fractures continues to evolve with time with flexible intramedullary nailing being one of the options to treat a specific age group of children. Grey zone exists concerning the cost effectiveness and appropriate timing of nail removal in treating such fractures. The objective of the study was to evaluate the treatment outcome of fracture shaft of the femur in children in the age group of 5- 12 years with flexible intramedullary nail.Methods: The study comprised of 30 consecutive cases of acute fractures of the femoral shaft in children of the age group of 5 to 12 years. Only closed fractures of the mid-diaphyseal region of the femur were included while supracondylar, subtrochanteric and pathological fractures were excluded. Flexible intramedullary nails of stainless steel (n=24) or titanium (n=6) were used for fixation of these fractures.Results: Evaluation of the results was done according to the criteria by Flynn et al. 21(70%) out of 30 patients had an excellent result and remaining 9 (30%) had a satisfactory result. All fractures united with a full range of motion at the hip and knee joint without any major complications. Conclusions: Intramedullary elastic nailing of simple diaphyseal femur fractures in children is an effective method with negligible complications. Treatment cost can be significantly lowered by using the much cheaper stainless steel flexible nails rather than the more expensive titanium nails.

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Femoral Shaft Fractures in Children: Traction and Casting versus Elastic Stable Intramedullary Nailing

Abstract: Less cost and comparable clinical outcome make ESIN a better option than traditional TXN/CST for femoral fracture care in the skeletally immature patient.

Cited by 128 publications

References 26 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

Intramedullary Kirschner wire (K-wire) fixation of femoral fracture in children

Flexible intramedullary nails: the panacea for paediatric femoral shaft fractures

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