Kirschner Wire Versus Titanium Elastic Nails in Pediatric Femoral Shaft Fractures

Işık, Cengiz; Kurtulmuş, Tuhan; Sağlam, Necdet; Saka, Gürsel; Akpınar, Fuat; Sarman, Hakan

doi:10.1590/1413-785220152305145030

Cited by 6 publications

(12 citation statements)

References 22 publications

(22 reference statements)

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“…Due to the osteoporosis, more than 2 cross pins are usually required for the stabilization (this may increase the risk of physeal damage) and the cast is associated. This approach has the advantage of being a simple low-cost technique, with no need for additional surgery for implant removal [ 19 ]; yet, rapid postoperative standing is hardly possible due to the cast weight, pain, and pin-related skin irritation [ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Flexible intramedullary nailing for supracondylar femoral fractures in children with Duchenne muscular dystrophy

et al. 2020

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Section: Discussionmentioning

confidence: 99%

Flexible intramedullary nailing for supracondylar femoral fractures in children with Duchenne muscular dystrophy

et al. 2020

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“…Overweight and obesity seem to increase the fracture risk [8][9][10], likely due to lower bone mass relative to body size and greater mechanical load caused by falls or reduced body balance [4][5][6][7][8][9][10][11][12][13]. Femoral shaft fractures are among the most common major injuries in pediatric age representing 1.4-1.7% of all fractures in pediatric population [14][15][16]. The etiology of the injury includes falls, motor vehicle accidents, sports injuries and child abuse.…”

Section: Introductionmentioning

confidence: 99%

“…Non-accidental injury has been reported as the leading cause of femur fractures in children less than 1 year old [17][18][19] and the AAOS recommends that children younger than 36 months with a diaphyseal femur fracture should be evaluated for child abuse [20]. The ideal treatment for a pediatric diaphyseal femur fracture is highly dependent upon age and size of the child but it should also consider weight, associated injuries, fracture pattern and mechanism of lesion [14][15][16][17][18][19][20][21][22]. The treatment should focus on getting the fracture to heal in an adequate alignment according to age, avoiding complications such as nonunion, delayed union, angular or rotational deformities, limb length discrepancy, infection, neurovascular injury, disruption of the growth plate, muscle weakness, and/or compartment syndrome [21].…”

Section: Introductionmentioning

confidence: 99%

“…Femoral shaft fractures are one of the most common pediatric orthopedic injury requiring hospitalization. Casting with or without preceding traction has been the mainstay of treatment in the past, leading to healing and remodeling with good long-term outcomes [14][15][16][17][18][19][20][21][22][23][24][25]. However, in the last decades there has been a gradual shift towards operative treatment in order to achieve a quicker recovery, shorter rehabilitation time and, simultaneously reducing the morbidity associated with prolonged immobilization [14][15][16][17][18][19][20][21][22][23][24][25][26].…”

Section: Introductionmentioning

confidence: 99%

“…Casting with or without preceding traction has been the mainstay of treatment in the past, leading to healing and remodeling with good long-term outcomes [14][15][16][17][18][19][20][21][22][23][24][25]. However, in the last decades there has been a gradual shift towards operative treatment in order to achieve a quicker recovery, shorter rehabilitation time and, simultaneously reducing the morbidity associated with prolonged immobilization [14][15][16][17][18][19][20][21][22][23][24][25][26]. With the development of age-adequate fixation devices, several different procedures are available for stabilization of femoral shaft fractures in children, such as external fixators, submuscular plates, rigid intramedullary nails and flexible intramedullary nails [14][15][16][17][18][19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

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Femoral Shaft Fractures in Pediatric Age: Treatment Strategies and Results

Carvalho

Alves

et al. 2020

OSMOAJ

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Purpose: Femoral shaft fractures represent 1.4-1.7% of all fractures in the pediatric population and may be associated with significant morbidity. The purposes of this study are to verify if increasing age and weight are predictive factors of associated injuries and complications in children with femoral shaft fractures.Methods: Retrospective study, including patients with age below 16 years old, admitted in our Department between 2011-2015, with the diagnosis of femoral shaft fracture. Patient demographics, fracture characteristics, associated injuries, treatment methods, time to union, follow-up and complications were collected from the medical records. Statistical significance was set for level of p<0.05.Results: Sixty patients were included. There was a male predominance [n=40]. Age at the time of injury was 6.3±4.9years old. The 61 femoral shaft fractures: observed affected different areas: 12-proximal; 43-middle; 6-distal. The most common etiology was direct trauma after a fall and traffic accident. Associated lesions were found to be significantly higher in older (p=0.01) and heavier (p=0.009) patients. Conservative treatment was the option for 62% of all fractures. The minimum age to surgery was 6 years old and rigid trochanteric entry nailing was only considered above 10 years old. Patients treated conservatively had a significant lower weight (16.4±8.4Kg) than those operated on (42.5±13.8Kg) [p<0.001]. Mean follow-up time was 50.4±56.8weeks and complications were reported in 15% of patients. We did not verify any statistically significant differences between post treatment complications and the treatment method (p=0.803). Conclusions:The age, weight and associated lesions were considered significant factors when choosing the treatment method.

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Practice Patterns for Management of Pediatric Femur Fractures in Low- and Middle-Income Countries

Curran¹,

Albright

Ibrahim

et al. 2019

Journal of Pediatric Orthopaedics

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Background: Femoral shaft fractures in children are common in low and middle income countries. In high-income countries, patient age, fracture pattern, associated injuries, child/family socioeconomic status, and surgeon preference dictate fracture management. There is limited literature on treatment patterns for pediatric femur fractures in resource-limited settings. This study surveys surgeons from low (LIC), lower-middle (LMIC), and upper-middle income (UMIC) countries regarding treatment patterns for pediatric femur fractures. Methods: Surgeons completed an electronic survey reporting surgeon demographics and treatment preference for pediatric femur fractures. Treatment preferences and indications for treatment were separated into 4 groups: infant (0 to 6 mo); toddler (7 mo to 4 y); child (5 to 12 y); adolescent (12 to 17 y). The survey was available in English, Spanish, and French. Analysis was completed with t test and χ2 test for continuous and categorical variables, respectively, and weighted Pearson correlation (P<0.05). Results: Survey respondents consisted of 413 surgeons from 83 countries (20 LIC, 33 LMIC, 30 UMIC). The majority of respondents were fellowship trained (83%) most commonly in pediatrics (26%) and trauma (43%). Most treated >10 pediatric femur fractures per year (68%). Respondents reported treating infant femur fractures nonoperatively using Pavlik harness (19%), spica cast (60%), or traction with delayed spica cast (14%). Decreasing socioeconomic status was associated with higher nonoperative treatment rate in toddlers, children, and adolescents. Respondents commonly utilize bed rest and traction for child femur fractures in LICs (63%) and LMICs (65%) compared with UMICs (35%) (UMIC vs. LMIC P<0.001; UMIC vs. LIC P<0.001). Surgeries in children more commonly involve open reduction with internal fixation (UMIC 19%, LMIC 33%, LIC 40%; P<0.05 between UMIC-LMIC and UMIC-LIC). Conclusion: This is one of the largest surveys describing treatment patterns for pediatric femur fractures in low and middle income countries. Differences are evident including lower operative treatment rate in younger children and lower intramedullary fixation rates in older children. Future studies should investigate the value of treatment options in resource-limited settings. Level of Evidence: Level II—prospective comparative study.

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Kirschner Wire Versus Titanium Elastic Nails in Pediatric Femoral Shaft Fractures

Cited by 6 publications

References 22 publications

Flexible intramedullary nailing for supracondylar femoral fractures in children with Duchenne muscular dystrophy

Flexible intramedullary nailing for supracondylar femoral fractures in children with Duchenne muscular dystrophy

Femoral Shaft Fractures in Pediatric Age: Treatment Strategies and Results

Practice Patterns for Management of Pediatric Femur Fractures in Low- and Middle-Income Countries

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