The use of elastic intramedullary nailing in the stabilisation of paediatric fractures

Berger, Philip K.; Graaf, J. S. de; Leemans, R.

doi:10.1016/j.injury.2005.05.012

Cited by 39 publications

(21 citation statements)

References 11 publications

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“…Infection and pain occurred in 10 patients (14 %). In published reports the risk of complications varies from 7 % to 40 % [3,7,15,17], and a significant increase of complaints has been reported when the nails protruded over 4 cm out of the femoral cortex. Narayanan et al [20] confirmed this, if the nails were bent outward from the cortex.…”

Section: Discussionmentioning

confidence: 99%

“…Gross strongly advocated cast bracing of any fracture [10] and a recent publication shows good results when combined with ESIF [22]. Even without casting, excellent results have been published with full-weight bearing in 5 days [3,17], resulting in zero LLDs exceeding 1 cm. We used an immobilisation of 2 to 3 weeks and partial weight bearing for 7 weeks.…”

Section: Discussionmentioning

confidence: 99%

“…Historically, traction treatment is aimed at a femoral shortening of 1 -2 cm in order to compensate for extra growth [3, 6 -8, 25, 30]. Femoral length increments after ESIF have been reported to be zero [2,3,5,7,13,22,24], 4 % [15], 10 and 14 % [6,17], and 18 to 47 % [18,27].…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Outcome of Elastic Stable Intramedullary Fixation (ESIF) of Femoral Fractures in Children

et al. 2006

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In 1993 a prospective data collection of all femoral fracture in children below 16 years of age was initiated in 4 hospitals in the Netherlands. Follow-up was at least two years, with the aim to evaluate leg length discrepancies (LLD). Over a period of 10 years, we included 136 patients < 16 years of age with femoral fractures. Seventy-one patients who were treated with an ESIF-(Elastic Stable Intramedullary Fixation) nail were studied: 44 boys and 27 girls, between the ages of 3-16 years, 23 of which had multiple injuries. Five patients had a Ist or IInd degree open fracture. The average length of stay (LOS) of children with an isolated fracture, was 10 days, and in case of multiple injuries: 12 days. Intra-operative complications were: a broken drill in 2 and an open reduction in 6 cases. Two patients with superficial wound infection were successfully treated with antibiotics. Seven patients had knee complaints of the nails, of which 3 had actually been displaced. Three other patients showed displacement of the nails at X-ray, but had no complaints. At six months follow-up, at the time of removal of the nails, 10 patients had a leg length discrepancy (LLD) exceeding 10 mm. Three children had a clinically significant rotational deformity at this time. Two and a half years after injury 6 patients showed a persistent LLD of more than 10 mm. In all 6 the fractured limb was longer. At ten years of follow-up the LLD persisted in 5 patients. One patient had a persistent clinically significant rotational deformity of more than 10 degrees . The advantages of ESIF-nails are: reduction of hospital stay and rapid mobilisation. The disadvantages: two operations (for insertion and removal) with a risk of complication. Long-term follow-up, preferably till growth stops, is necessary to conclude whether persistent lengthening of the fractured limb remains a problem.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Long-Term Outcome of Elastic Stable Intramedullary Fixation (ESIF) of Femoral Fractures in Children

et al. 2006

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“…2, [11][12][13][14][15][16] Titanium elastic nails have been used successfully in the treatment of diaphyseal long bone fracture in children and adolescents, using minimally invasive techniques. [17][18][19] Jubel et al 20 first described the use of titanium elastic nails for midclavicular fracture fixation. The use of titanium elastic nails to fix midclavicular fractures requires a minimally invasive method, using a small incision and minimal soft tissue dissection under fluoroscopic guidance.…”

Section: Figurementioning

confidence: 99%

Complications and Technical Pitfalls of Titanium Elastic Nail Fixation for Midclavicular Fractures

Lu¹,

Liu²,

Huang³

et al. 2014

Orthopedics

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Intramedullary titanium elastic nails have been reported to fix displaced midclavicular fractures with excellent functional outcomes and minor complications. This study reports and analyzes the complications and technical pitfalls associated with titanium elastic nail fixation of displaced midclavicular fractures and describes how to prevent these problems. The authors operated on 27 patients (17 men, 10 women; mean age, 45.8 years; range, 16.5-66.9 years) with marked displaced midclavicular fractures using intramedullary titanium elastic nail fixation. The mean Constant score and Disability of the Arm, Shoulder, and Hand score were 93.58 (range, 66.5-100) and 6.22 (range, 0-35), respectively. The mean length difference compared with the contralateral clavicle was a shortening of 0.3 cm (range, -1.5 to 1 cm). Eight patients (30%) had different levels of difficulty at the medial entry point. Clavicular length shortening of more than 1 cm occurred in 5 patients (19%), and all of these patients experienced medial nail tip prominence/protrusion. One patient had 1-cm lengthening of the injured clavicle caused by distraction of the fracture site during titanium elastic nail insertion. Iatrogenic perforation of the posterolateral cortex occurred in 3 patients. Initial misplaced nail insertion occurred in 1 woman who underwent revision with the mini-open method. In 2 patients it was impossible to remove the full nail under general anesthesia. In conclusion, high patient satisfaction and functional outcomes were achieved after titanium elastic nail fixation of displaced midclavicular fractures. However, some complications and technical pitfalls must be considered before titanium elastic nails are used to fix displaced midclavicular fractures.

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“…Berger i sar. 10 preporučuju lečenje preloma femura intramedularnom osteosintezom rigidnim klinovima kod dece uzrasta preko 15 godina, dok u grupi od četiri do 15 godina predlažu tretman elastičnim klinovima. Fyodorov i sar.…”

Section: Diskusijaunclassified

Pediatric femur fractures, epidemiology and treatment

Petković

Djan

Gajdobranski

et al. 2011

VSP

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The use of elastic intramedullary nailing in the stabilisation of paediatric fractures

Cited by 39 publications

References 11 publications

Long-Term Outcome of Elastic Stable Intramedullary Fixation (ESIF) of Femoral Fractures in Children

Long-Term Outcome of Elastic Stable Intramedullary Fixation (ESIF) of Femoral Fractures in Children

Complications and Technical Pitfalls of Titanium Elastic Nail Fixation for Midclavicular Fractures

Pediatric femur fractures, epidemiology and treatment

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