Abstract:We analysed retrospectively the risk factors leading to femoral overgrowth after flexible intramedullary nailing in 43 children (mean age 7.1 years (3.6 to 12.0)) with fractures of the shaft of the femur. We reviewed their demographic data, mechanism of injury, associated injuries, the type and location of the fractures, the nail-canal diameter (NCD) ratios and femoral overgrowth at a mean follow-up of 40.7 months (25.2 to 92.7). At that time, the children were divided into two groups, those with femoral overg… Show more
“…In line with our findings, Fakoor et al [19] also reported that age, gender, weight and fracture location had no effect on postoperative length changes. Moreover, the results of our study also suggested that concomitant head trauma and the cause of injuries had no significant relationship with limb overgrowth, which was consistent with Park's results [20].…”
“…In line with our findings, Fakoor et al [19] also reported that age, gender, weight and fracture location had no effect on postoperative length changes. Moreover, the results of our study also suggested that concomitant head trauma and the cause of injuries had no significant relationship with limb overgrowth, which was consistent with Park's results [20].…”
“…81 Age, size of child and the site and pattern of the fracture are factors that govern the type of operative management, including the use of an ESIN, internal fixation with a plate via a traditional open or a minimally invasive approach, external fixation, and even rigid intramedullary fixation. [82][83][84][85][86][87] The forms of surgical treatment available for the management of these fractures in children over five years of age have evolved significantly over time, partly influenced by socioeconomic factors, as a shorter hospital stay was thought to have psychological, educational, social and economic advantages. 88 Before this, these children were usually managed with a hip spica.…”
The management of children's fractures has evolved as a result of better health education, changes in lifestyle, improved implant technology and the changing expectations of society. This review focuses on the changes seen in paediatric fractures, including epidemiology, the increasing problems of obesity, the mechanisms of injury, non-accidental injuries and litigation. We also examine the changes in the management of fractures at three specific sites: the supracondylar humerus, femoral shaft and forearm. There has been an increasing trend towards surgical stabilisation of these fractures. The reasons for this are multifactorial, including societal expectations of a perfect result and reduced hospital stay. Reduced hospital stay is beneficial to the social, educational and psychological needs of the child and beneficial to society as a whole, due to reduced costs.
“…Complications due to flexible intramedullary nails to treat pediatric diaphyseal femur fractures include loss of reduction, nonunions, malunion and leg length discrepancy ( 2 ). Symptomatic hardware can be seen in up to 23% of patients ( 3 ).…”
We present a case report of acute spontaneous knee hemarthosis due to erosion of the nail through the knee joint capsule in a boy, seven months following retrograde flexible nailing for fractured femur. Careful positioning of the location of the insertion site of flexible nails and proper nail tip management are important to avoid this rare late complication.
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