Pitfalls of femoral Titanium Elastic Nailing

Salonen, Anne; Lahdes-Vasama, Tuija; Mattila, Ville M.; Välipakka, Jarmo; Pajulo, Olli

doi:10.1177/1457496914529275

Cited by 13 publications

(11 citation statements)

References 31 publications

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“…In the case of distal fractures, stabilization is more difficult and several approaches are possible [ 5 – 7 ]: retrograde C-shaped approach, with the convex side of both nails at the level of the fracture. The unbent nails are inserted into the medullary canal, and when the distance to the fracture site is equal to the length of the nails outside the bone, their bending is performed; retrograde C-shaped approach, in which the nails are crossed proximally to the fracture site; antegrade approach with C- and S-shaped nails.…”

Section: Femoral Fracturesmentioning

confidence: 99%

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Elastic stable intramedullary nailing for fractures in children – specific applications

Cosma

Vasilescu

2014

Medicine and Pharmacy Reports

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Elastic stable intramedullary nailing (ESIN) is a new minimally invasive technique for the treatment of pediatric fractures. It approximates the physiological healing process of bone, without opening the fracture site. Also, the operative stress is minimal because of the minimally invasive nature of the procedure, and the volume of implants is small, offering a very good stability without plaster cast immobilization.

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Section: Femoral Fracturesmentioning

confidence: 99%

“…Femoral neck fractures do not have an indication for ESIN because of the high density of the trabecular bone in the proximal femoral metaphysis, which makes the advancement and insertion of elastic nails difficult [ 5 – 7 ].…”

Section: Femoral Fracturesmentioning

confidence: 99%

Elastic stable intramedullary nailing for fractures in children – specific applications

Cosma

Vasilescu

2014

Medicine and Pharmacy Reports

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“…The use of this method has very few restrictions, therefore it can be used in almost every age group. However, there are some authors claiming this method to be overly and uncontrollably used [43][44][45] .…”

Section: Introductionmentioning

confidence: 99%

Treatment of Pediatric Femoral Fractures in the City of Zagreb

Antabak

Boršćak

Čagalj

et al. 2020

ACC

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Femur fractures in children can be treated with a number of operative and conservative methods. Numerous factors determine which method is optimal for a specific fracture. The aim of this research was to analyze distribution of femur fractures in children living in the urban communities of Zagreb and Zagreb County by localization, type and frequency of treatment methods used according to age and fracture mechanism. The research included 103 children aged up to 18 years, treated for femur fractures at the Zagreb University Hospital Centre and Zagreb Children's Hospital. Data were collected from these institutions and a retrospective study covered the 2010-2015 period. The cause of fracture and diagnosis were coded with the help of the International Statistical Classification of Diseases and Related Health Problems. Operative treatment was applied in 55% of cases, which is contrary to previous researches. The highest incidence of femur fractures was recorded in the 0-to 4-year age groups, accounting for 49.1% of all fractures. These fractures mostly occurred due to falls and were more often treated with non-operative methods. All other age groups were mostly treated with operative methods. Coxofemoral immobilization and traction were used as non-operative methods, whereas flexible intramedullary nailing was the most frequently used operative method. The treatment depended on age, complexity of the fracture, fracture type, fragment displacement, and associated injuries. The cause was also an important factor on choosing the treatment method. Nonoperative treatment was mostly used for fractures caused by falls (64.71% of cases due to falls) and operative treatment was mostly used for fractures caused by traffic accidents (79.4% of cases due to traffic accidents). It is a wide-known opinion that the best treatment for femur fractures in children is non-operative treatment. However, recent studies have shown that the use of operative methods in femur fracture treatment is growing. Our cohort of children treated during a five-year period (2010)(2011)(2012)(2013)(2014)(2015) also underwent operative treatment more often than non-operative one. Two non-operative and eight operative methods were used. With such a large number of methods, it is clear that there is no unique method for all fractures. However, it is clear that the trend of using operative treatment is connected to the perennial trend of considerable sociodemographic and socioeconomic changes in urban settings such as Zagreb. Lifestyle changes directly affect the prevalence of femur fractures among children, as well as approach to treatment choice. General opinion is that most of fractures that occur at an early age can be treated with non-operative methods. Our research on femur fractures in children confirmed this rule. The youngest age group that had the highest incidence of fractures (49.1% of all fractures) was treated with non-operative methods in 75% of cases. Operative methods prevailed in other age groups. Similar results have been published by other ...

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“…Although generally considered to be a safe procedure, complications have been reported after the fixation of pediatric femur fractures with intramedullary implants and include pain at nail insertion site, nail prominence, superficial and deep infections, mal-angulation, hematoma, neurologic damage, delayed union or nonunion, and loss of reduction [ 4 , 14 , 15 ]. Previously reported risk factors for complications and poor outcomes include older age, increased weight [ 3 , 4 ], improper sizing of the nail [ 16 ], and type of nail (rigid antegrade vs. elastic retrograde) [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for complications and readmission after operative fixation of pediatric femur fractures

Momaya

Baker

Gilbert

et al. 2015

Journal of Children's Orthopaedics

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PurposeOperative fixation of pediatric femur fractures with intramedullary implants has grown in popularity in recent decades. However, risk factors for short-term adverse events and readmission have not been well studied.MethodsPediatric patients who underwent intramedullary nailing of a femur fracture between 2012 and 2013 were identified from the American College of Surgeons National Surgical Quality Improvement Program database. Risk factors for any adverse event (AAE) and readmission after intramedullary nailing were evaluated using univariate and multivariate analysis.ResultsA total of 522 pediatric patients who underwent intramedullary nailing of the femur during the study period were identified. The mean age of this patient cohort was 10.2 ± 3.8 years. Review of the cases revealed that 18 (3.4 %) patients had AAE and that 20 (3.8 %) patients were readmitted, of whom 13 (2.5 %) underwent a reoperation. Independent risk factors for AAE were a cardiac comorbidity [odds ratio (OR) 12.7, 95 % confidence interval (CI) 1.5, 103.7], open fracture (OR 10.2, 95 % CI 1.4, 74.4), and prolonged operative time (OR 17.5, 95 % CI 6.1, 50.5). Independent risk factors for readmission were a central nervous system disorder (OR 4.5, 95 % CI 1.3, 16.2) and a seizure disorder (OR 4.9, 95 % CI 1.0, 23.5).ConclusionsThe results of the multivariate analysis suggest that cardiac comorbidities, open fractures, and prolonged operative time increase the risk for AAE and that central nervous system disorders and seizure disorders may increase the risk for readmission. Surgeons should be aware of these risk factors and counsel the families of pediatric patients who undergo intramedullary nailing of femur fractures.

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Pitfalls of femoral Titanium Elastic Nailing

Cited by 13 publications

References 31 publications

Elastic stable intramedullary nailing for fractures in children – specific applications

Elastic stable intramedullary nailing for fractures in children – specific applications

Treatment of Pediatric Femoral Fractures in the City of Zagreb

Risk factors for complications and readmission after operative fixation of pediatric femur fractures

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