Elastic stable intramedullary nailing (ESIN) in paediatric femur and tibia shaft fractures: Comparison between titanium and stainless steel nails

AbstractTibia fractures are among the most common long-bone fractures in children. Despite this, there is no current consensus on the optimal treatment strategy for closed displaced tibia shaft fractures in the pediatric patient population. The aim of this study is to compare the reported complications and outcomes of reduction and cast immobilization versus flexible intramedullary nailing in the treatment of pediatric tibia shaft fractures. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement when conducting and reporting this prospectively registered systematic review. Eleven studies were included. Quality of the studies was assessed using the Coleman methodology score. Mantel–Haenszel cumulative odds ratios were used to compare the risk of complication between different methods of treatment. Eleven studies including 1,083 patients with diaphyseal fractures of the tibia met the inclusion criteria. The most common fracture type was simple 42-A (782; 91%). Majority (75%) of the patients were treated nonoperatively. The total complication rate was higher among operatively treated patients (24 vs. 9%; p < 0.05). Satisfactory fracture alignment had to be restored surgically in 5% of the primarily nonoperatively treated patients. The evidence levels of the included studies were II (1), III (2), and IV (7). Three-fourths of closed diaphyseal fractures of the tibia in children are still treated with reduction and cast immobilization. Flexible intramedullary nailing is associated with significantly higher complication rate than nonoperative treatment.

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Retraction notice to “A randomised prospective study of two different combined internal and external fixation techniques for distal tibia shaft fractures” [Injury 45 (2014) 1990 - 1995]

Injury ◽

10.1016/j.injury.2015.06.031 ◽

2015 ◽

Vol 46 (8) ◽

pp. 1700

Author(s):

Liao-Jun Sun ◽

Xian-Bin Yu ◽

Cheng-Qian Dai ◽

Wei Hu ◽

Xiao-Shan Guo ◽

...

Keyword(s):

Prospective Study ◽

External Fixation ◽

Distal Tibia ◽

Shaft Fractures ◽

Tibia Shaft Fractures ◽

Fixation Techniques ◽

Retraction Notice ◽

Tibia Shaft

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Segmental Tibia Shaft Fractures – Extra Articular Ilizarov Reduction Techniques

Fracture Reduction and Fixation Techniques ◽

10.1007/978-3-030-24608-2_27 ◽

2020 ◽

pp. 351-371

Author(s):

Paul Harwood ◽

David Martin Taylor

Keyword(s):

Reduction Techniques ◽

Shaft Fractures ◽

Tibia Shaft Fractures ◽

Tibia Shaft

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Elastic Stable Intramedullary Nailing for Treatment of Pediatric Tibial Fractures

Journal of Lumbini Medical College ◽

10.22502/jlmc.v4i1.82 ◽

2016 ◽

Vol 4 (1) ◽

pp. 11

Author(s):

Sandeep Gurung ◽

Dipendra KC ◽

Roshni Khatri

Keyword(s):

Intramedullary Nailing ◽

Demographic Data ◽

Elastic Stable Intramedullary Nailing ◽

Tibial Shaft ◽

Elastic Stable Intramedullary Nail ◽

Shaft Fractures ◽

Tibia Fractures ◽

One Year ◽

Skeletally Immature Patient ◽

Tibial Shaft Fractures

Introduction: Tibia fractures in the skeletally immature patient can usually be treated with above knee cast or patellar tendon bearing cast. The purpose of our study was to evaluate epidemiology and outcome of Elastic stable intramedullary nailing fixation of pediatric tibial shaft fractures treated at our institution. Methods: Over a period of one year, fifty pediatric patients of tibial shaft fractures, with average age of 9.68 yr (SD=2.37), were treated with elastic stable intramedullary nail. Demographic data, union and complication rate were evaluated. Results: There were 36 closed and 14 open fractures. The average time to union was 11.6 weeks (SD=2.65) for close and 14.3 weeks (SD=2.62) for open fracture. There were no instances of growth arrest, remanipulations, or refracture. Conclusion: We conclude that flexible intramedullary fixation is an easy and effective method of management of both open and closed unstable fractures of the tibia in children.

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