Paediatric Long Bone Fractures Managed with Elastic Intramedullary Nails: A Retrospective Study of 30 Patients

Khuntia, Susanta; Swaroop, Shakti; Patro, Bishnu Prasad; Sahu, S. C

doi:10.7759/cureus.7847

Cited by 9 publications

(20 citation statements)

References 31 publications

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“…Due to the curative treatment, mild trauma and simple removal, many scholars have suggested that TEN are an ideal technique for the treatment of fractures in children in recent years. [ 10 , 11 , 24 ] For older or heavier children, because the biomechanical properties of TEN cannot be fully utilized, must carefully when choosing treatment. Moroz et al [ 25 ] noted that children older than 11 years and heavier than 49 kg are more likely to have a complication or a poor outcome.…”

Section: Discussionmentioning

confidence: 99%

“…The advantages of TEN in the treatment of fractures in children: it would exploit a child's denser bone, rapid healing, and ability to remodel, without risking the epiphysis or blood supply to the femoral head [ 28 ] ; it allows a biological environment that enhances both the rate of fracture healing and the quantity of callus formation [ 29 ] ; the elasticity of the construct allows for the ideal of micro-motion for rapid fracture healing [ 30 ] ; provides biomechanical stability such as axial, lateral, bending resistance, and rotation resistance [ 10 ] ; It only has two minimally invasive incisions at the metaphysis , that avoid damage to epiphyseal plate and do not affect blood supply; and the incision is beautiful in appearance and the internal fixation is easy to remove. Based on the advantages above, we think TEN has great superiority in treating of Delbet IV femoral neck fractures in 6 to 10 years children.…”

Section: Discussionmentioning

confidence: 99%

“…Several recent studies suggested that titanium elastic nail (TEN) not damage the periosteum, and become the ideal device for care for most pediatric long bone. [ 10 ] However, no studies focused on the treatment by TEN of the children suffering from femur neck fracture. The purposes of this study are to compare outcome of TEN and SC in Delbet IV femur neck fracture in 6 to 10-years children and to share our experience in the treatment of Delbet IV femur neck fracture.…”

Section: Introductionmentioning

confidence: 99%

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Titanium elastic nailing can be used in 6 to 10 years old pediatric with Delbet IV femoral neck fractures

Zhu¹,

Xu²,

Zhang³

et al. 2021

Medicine

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The purpose of this study was to analyze the outcomes of titanium elastic nail (TEN) for the children in 6 to 10 years old who sustained a Delbet IV femoral neck fracture.A total of 56 children aged 6 to 10 years old with Delbet IV femoral neck fracture treated with TEN or cannulated screw (SC) were identified at our hospital from January 2009 to December 2019. Of which 24 were treated with TEN, and 32 with SC. All of them were followed up for 1 year after operation, and the differences in operation time, intraoperative blood loss, hospitalization time, hip joint function, and complication between the 2 groups were compared. Harris and Ratliff hip score were used to evaluate the hip function.All 56 fractures united properly. No major complications were noted in both groups. The intraoperative blood loss and operation time in TEN group and SC group were (11.42 ± 3.41) mL, (19.66 ± 4.05) mL (P = .000) and (33.58 ± 7.89) min, (40.22 ± 7.48) min (P = .002), respectively. There was no significant statistical difference between hip regarding range of motion and femoral neck-shaft angle in both groups, as well as Harris and Ratliff hip score between the 2 groups.TEN represent safe and effective methods in the treatment of Delbet IV femoral neck fracture in 6 to 10 years old children. TEN internal fixation is a minimal invasive and simpler technique and suitable for young children of Delbet IV femoral neck fracture.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Titanium elastic nailing can be used in 6 to 10 years old pediatric with Delbet IV femoral neck fractures

Zhu¹,

Xu²,

Zhang³

et al. 2021

Medicine

View full text Add to dashboard Cite

show abstract

“…Ina recent study, Khuntia et al retrospectively reviewed paediatric long bone fractures operated with an elastic intramedullary nail. 9 Gavaskar and Singh performed a prospective study to evaluate the operative outcomes of paediatric diaphyseal fractures in the age group between 5 to 12 years using TEN. 10 In their study 47% of the patients were aged less than 8 years and 70% were males.…”

Section: Discussionmentioning

confidence: 99%

Pediatric long bone fractures treated by elastic intramedullary nailing

Gupta

Chaurasia

Jha³

2021

Int J Res Orthop

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Background: Pediatric long bone fractures can have a high morbidity and long term disability among the survivors. The present study was aimed to study the clinical outcomes of children with long bone fractures managed by elastic intramedullary nail.Methods: We retrospectively reviewed the medical records of children (aged 2 to 15 years) who were admitted and treated for unilateral femoral, tibial or forearm fractures with elastic intramedullary nail from January 2018 till February 2020. All were managed with elastic intramedullary nailing. The union times and complications were noted from the medical records.Results: Femoral, tibial and forearm bones were involved in 15 patients each (33.3%). Road traffic accident was reported by 31%) and physical abuse by one case (2%). The mean time of union was 10 weeks, ranging from 6 to 12 weeks. The mean time for union of the femur and tibia was 11.54 and 11.34 weeks respectively. It was significantly lower for forearm (6.67 weeks, p value <0.05). Two patients reported of bursitis and impingement, which were resolved after nail removal. One case had limb length discrepancy of about 0.5 cm in femur fracture, which was not impairing functional activity. Functional status was assessed based on Flynn criteria was found to be excellent in 36%, good in 44% and fair in 20%.Conclusions: The results of the present study show that titanium elastic nail (TEN) is an effective treatment modality for managing pediatric long bone fractures. We recommend the use of TEN in managing long bone fractures in children.

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“…Most TDF are treated with cast immobilization and closed reduction, however in cases where these methods do not provide an acceptable reduction in injures, surgical intervention such as external fixation and plate and screw fixation is used 7,10 . Over the last decade use of titanium elastic nailing (TEN) has been used to treat pediatric TDF to achieve optimum post-operative results with a low rate of complications [9][10][11] . TEN as compared to the external fixation offers minimal intrusion using small incisions and provides fewer chances of surgical trauma to the fracture site allowing early union and rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

Functional Outcome of Titanium Elastic Nailing in Pediatric Tibial Fracture

2022

PJMD

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Background: Tibial Diaphyseal fracture (TDF) is the third most common fracture seen in the pediatric population. Titanium elastic nailing (TEN) has been ideal for the management of tibial diaphyseal fractures to prevent complications. Therefore, this study aimed to access the functional outcome of TEN in pediatric Tibial diaphyseal fracture. Methods: This prospective cohort study was conducted on n=87 skeletally immature patients (6-12 years) at the two hospitals in Karachi from 1st November 2019-30th April 2021 including patients having unilateral, closed Tibial Diaphyseal fracture. The 75 patients (12 of them were lost follow-up) were analyzed in terms of wound infection, union, weight-bearing, limb shortening, rotation, angulation, and range of movement at knee and ankle joints. Paired t-test was used to compare the variables with a p-value < 0.05 was considered statistically significant. Results: Patients n=75 in this study had a mean age of 8.32±1.92 years with a mean weight of 25.8±6.9. The most frequent cause of injury was traffic accident 49(65.3%), followed by falling 19(25.3%) and 7(9.4%) with other causes. The most common fracture type was transverse 45(60%), followed by oblique 26(34.7%), and the remaining 4(5.3%) had a spiral fracture. All patients were allowed full weight-bearing at 9.8 ±1.5 week. At the end of this study, all patients regained knee and ankle range of motion (p< 0.0001). Conclusion: Titanium elastic nailing was the ideal procedure for Tibial Diaphyseal fracture in the pediatric population, resulting in a short hospital stay, a rapid rehabilitation without complications. Keywords: Pediatrics; Pediatric Tibial Diaphyseal Fracture; Titanium; Titanium Elastic Nailing; Functional Outcome; Movement.

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Paediatric Long Bone Fractures Managed with Elastic Intramedullary Nails: A Retrospective Study of 30 Patients

Cited by 9 publications

References 31 publications

Titanium elastic nailing can be used in 6 to 10 years old pediatric with Delbet IV femoral neck fractures

Titanium elastic nailing can be used in 6 to 10 years old pediatric with Delbet IV femoral neck fractures

Pediatric long bone fractures treated by elastic intramedullary nailing

Functional Outcome of Titanium Elastic Nailing in Pediatric Tibial Fracture

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