Influence of the bending of the tip of elastic stable intramedullary nails on removal and associated complications in pediatric both bone forearm fractures: A pilot study

Gibon, Emmanuel; Beranger, J; Bachy, Manon; Delpont, Marion; Kabbaj, R.; Vialle, Raphaël

doi:10.1016/j.ijsu.2015.02.003

Cited by 14 publications

(13 citation statements)

References 21 publications

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“…TEN with a diameter of 2.5 mm is recommended for children aged 6-10 years, and 3.0-3.5 mm is recommended for children over 10 years; (ii) the thicker the TEN, the stronger the elasticity and fixation. However, the difficulty of insertion will increase; and (iii) postoperative irritability reaction around nails should be watched 42,43 .…”

Section: Clinical Experience For Treating Pediatric Humeralmentioning

confidence: 99%

Comparison of Open Reduction and Internal Fixation with Plate and Titanium Elastic Intramedullary Nail in Treating Pediatric Humeral Fracture

Jinsong

Huang

Chen

et al. 2021

Orthopaedic Surgery

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Objective: To investigate the therapeutic efficacy of titanium elastic intramedullary nail (TEN) and open reduction and internal fixation with plate (ORIF) in the treatment of humeral fracture in children. Methods: A retrospective study was carried out in a total of 69 patients who were admitted to the hospital from January 2013 to December 2018. These patients, including 41 males and 28 females, were aged from 6 to 12 years old with a median of 8 years. These patients were diagnosed with humeral fracture and underwent the surgery of ORIF (n = 22) or TEN (n = 47). The intraoperative bleeding, operation time, length of stay (LOS), and fracture healing time were compared between the two groups. The therapeutic effect was assessed by the shoulder range of motion, the elbow range of motion, the UCLA shoulder function score, and the Mayo elbow performance score (MEPS) 6 months after the surgery.

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Section: Clinical Experience For Treating Pediatric Humeralmentioning

confidence: 99%

Comparison of Open Reduction and Internal Fixation with Plate and Titanium Elastic Intramedullary Nail in Treating Pediatric Humeral Fracture

Jinsong

Huang

Chen

et al. 2021

Orthopaedic Surgery

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“…Cutting and bending the nail under the skin and above the level of the tendon helps to reduce the risk of skin irritation. [ 24 ] Reviewing the literature and our experiences we came to the conclusion that optimisation of the insertion point and the position of the extraosseal end of the nails can reduce the risk of both acute and chronic ruptures. Intraoperative ultrasound has been proven an easy and useful tool for visualizing these optimal reference points.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative sonography may reduce the risk of extensor pollicis longus tendon injury during dorsal entry elastic intramedullary nailing of the radius in children

et al. 2018

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Extensor pollicis longus tendon (EPL) injury is a potential complication of dorsal entry radial elastic nailing technique in children. The aim of this study was to investigate if intraoperative ultrasonographic guidance can reduce the risk of (EPL) injury.Correlation between sonographic and operative findings were examined first in 6 adult cadavers. Position of Lister's tubercle, EPL, and extraosseal end of the elastic nail were detected by ultrasound imaging during a minimally invasive dorsal entry nailing. Radial slope of Lister's eminence was determined as a safe and easily identifiable entry point for opening the medullary canal. Extraosseal ends of the nails were bended in a slight radial direction and cut immediately beneath the skin in a maximally palmar-flexed wrist position. Cadaveric dissections followed our procedures all correlated with ultrasonographic findings, we have not seen tendon damage, obstruction or friction by the implant's end.After cadaveric experiments, we began using intraoperative sonography for monitoring elastic nail insertion in pediatric radial fractures.Between January 2015 and November 2016, 77 pediatric closed diaphyseal radial fractures were operated by dorsal approach ESIN under intraoperative sonographic checking.Procedures were executed by 2 orthopedic surgeons experienced in ESIN technique with basic musculoskeletal ultrasonographic qualifications.Sonographic identification of EPL and Lister's tubercle in the transverse view was possible in all cases. Determination of the position of the nail end to EPL was also possible in all cases. Mean distance of the transverse view center of the EPL and nail was 0.49 cm (range 0.3–0.62 cm, SD = 0.66). Based on the sonographic transverse view, the operator decided repositioning the nails by 2 patients.We have not found EPL injury postoperatively. All patients were followed for at least 12 months after operations. Nails were removed in all children without further complications.Intraoperative sonography helps determining optimal insertion point and the risk of EPL injury may be reduced during dorsal entry approach.Although the procedure is relatively easy, authors take note that surgical and sonoanatomic knowledge, basic sonographic skills and experience in the ESIN technique are equally necessary for its successful application. A greater number of cases is necessary to confirm our initial promising experiences.

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“…Flynn et al [39] reported rupture of the EPL tendon due to an injury from the ESIN in 2 of 103 patients (1.9%), which is close to our rate of 1.5%. Gibbon et al [40] recently published an investigation recommending bending of the ESIN tip and suggested tip bending of 180° before burying to prevent skin irritations and additional procedures. Only 1 superficial wound infection at the radial insertion point occurred after implant removal and was locally treated; no deep infection was observed even after open fractures.…”

Section: Discussionmentioning

confidence: 99%

Low complication rate of elastic stable intramedullary nailing (ESIN) of pediatric forearm fractures

et al. 2017

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Influence of the bending of the tip of elastic stable intramedullary nails on removal and associated complications in pediatric both bone forearm fractures: A pilot study

Abstract: Level III—retrospective comparative study.

Cited by 14 publications

References 21 publications

Comparison of Open Reduction and Internal Fixation with Plate and Titanium Elastic Intramedullary Nail in Treating Pediatric Humeral Fracture

Comparison of Open Reduction and Internal Fixation with Plate and Titanium Elastic Intramedullary Nail in Treating Pediatric Humeral Fracture

Intraoperative sonography may reduce the risk of extensor pollicis longus tendon injury during dorsal entry elastic intramedullary nailing of the radius in children

Low complication rate of elastic stable intramedullary nailing (ESIN) of pediatric forearm fractures

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