Is mini-open intramedullary nailing an effective intervention for adult femoral diaphyseal fractures in odd hours? A prospective case-control functional outcome and radiation safety study.

Injury ◽  
2020 ◽  
Author(s):  
Bobby Nandhimandalam ◽  
Saubhik Das ◽  
Shreyas Zalariya ◽  
Md Quamar Azam ◽  
Anurag Mittal
Keyword(s):  
Functional Outcome ◽  
Intramedullary Nailing ◽  
Radiation Safety ◽  
Case Control ◽  
Effective Intervention ◽  
Safety Study ◽  
Diaphyseal Fractures ◽  
Control Functional ◽  
Mini Open

scholarly journals Functional outcome of elastic intramedullary nailing of forearm fractures in children using pin leverage technique

2019 ◽  
Vol 5 (4) ◽  
pp. 661
Author(s):  
Alamgir Jhan ◽  
Wazir Fahad Jan ◽  
Ganesh Singh Dharamshaktu ◽  
Tajinder Bhalla ◽  
Saika Rasool ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Intramedullary Nailing ◽  
Closed Reduction ◽  
Tertiary Care ◽  
Plaster Cast ◽  
Forearm Fractures ◽  
Tertiary Care Centre ◽  
Fractures In Children ◽  
Diaphyseal Fractures ◽  
Elastic Intramedullary Nailing

<p class="abstract"><strong>Background:</strong> There is a recent trend towards elastic intramedullary nailing in fixation of pediatric forearm bone diaphyseal fractures. But in children we should always attempt closed reduction and immobilsation in a moulded plaster cast. Irreducible, open fractures and those that get redisplaced in moulded plaster cast need operative fixation with intramedullary nailing. Our aim was to know the outcome of tens nailing in such fractures.</p><p class="abstract"><strong>Methods:</strong> We studied functional and radiological outcome of elastic intramedullary nailing by pin leverage technique in forearm fractures in 34 children. The study was done at a tertiary care centre in Uttrakhand, India from May, 2016 to July, 2018. Inclusion criteria were closed forearm fractures; diaphyseal fractures; age 1 to 19 years. Exclusion criteria were open type 2 and type 3 Gustillo-Anderson fractures; metaphyseal, epiphyseal forearm fractures; age &gt;19 years; pathological fractures.<strong></strong></p><p class="abstract"><strong>Results:</strong> Closed reduction and percutaneous pin leverage technique for reduction was successful in all but 4 patients where limited open reduction was used for reduction of fracture fragments. All fractures united radiologically between 7 to 13 weeks with mean distribution of 9.2 weeks. For functional outcome we used modified Price and Daruwala’s score. 28 patients showed excellent results and 6 patients showed good results. All our patients had radiological union in mean of 9.2 weeks (7-13 weeks).</p><p><strong>Conclusions:</strong> Fixation with intramedullary TENS nailing is an effective and affordable way of treating patients in paediatric age group.</p>

scholarly journals Functional outcome of elastic stable intramedullary nailing of diaphyseal fractures of paediatric long bones

2016 ◽  
Vol 2 (4) ◽  
pp. 359
Author(s):  
Arun Vashisht ◽  
Gaurav Dev Sharma
Keyword(s):  
Conservative Treatment ◽  
Functional Outcome ◽  
Intramedullary Nailing ◽  
Weight Bearing ◽  
Elastic Stable Intramedullary Nailing ◽  
Personal Hygiene ◽  
Long Bones ◽  
Forearm Bones ◽  
Diaphyseal Fractures ◽  
Partial Weight

<p class="abstract"><strong>Background:</strong> After the advent of titanium elastic nails (TENs) and gratifying results of elastic stable intramedullary nailing (ESIN) in diaphyseal fractures of paediatric long bones, not only the parents of patients are opting surgical treatment over conservative, but also more and more orthopaedicians are offering ESIN with TENs to obviate the inherent problems of conservative treatment. We took up this study to evaluate the functional outcome of ESIN with TENs<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> 44 patients aged 5-15 years suffering from diaphyseal fractures of femur, tibia, humerus, and forearm bones were treated by ESIN with TENs.<strong></strong></p><p class="abstract"><strong>Results:</strong> All 44 patients showed uneventful union, femur in an average period of 8.3 weeks, tibia in 7.3 weeks, forearm bones within 7 weeks and humerus in 7.5 weeks. Commonest complication was pain at insertion site. 1 femur patient had lengthening of 1.5 cm. 1 femur and 1 forearm patient showed joint stiffness. No patient had delayed/non-union, sagittal/coronal/rotational mal-union, and deep infection. Partial weight bearing (PWB) started from 2<sup>nd</sup>/3<sup>rd</sup> day attaining full weight bearing (FWB) in 6-10 weeks<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> ESIN with TENs appears logical and safe to obviate the inherent problems of conservative treatment, as ESIN is least invasive and allows early PWB/FWB leading to early independence of personal hygiene/toilet use with early social integration/return to school<span lang="EN-IN">.</span></p>

scholarly journals Functional outcome of diaphyseal fractures of forearm in adolescents treated with TENS

2019 ◽  
Vol 5 (3) ◽  
pp. 69
Author(s):  
Divyanshu Goyal ◽  
S. L. Sharma ◽  
Laxmikant Meena ◽  
Ravindra Lamoria ◽  
Mahesh Bansal
Keyword(s):  
Range Of Motion ◽  
Functional Outcome ◽  
Case Series ◽  
Age Group ◽  
Forearm Fractures ◽  
Retrospective Case ◽  
Superficial Infection ◽  
Fractures In Children ◽  
Case Series Study ◽  
Diaphyseal Fractures

<p class="abstract"><strong>Background:</strong> A retrospective case series study was done on forearm diaphyseal fracture in adolescents treated with TENS (titanium elastic nailing system). Purpose of the study was analysis of functional outcome of TENS in forearm diaphyseal fractures in children between 12-18 year age group.</p><p class="abstract"><strong>Methods:</strong> We retrospectively evaluated 30 patients operated by same senior surgeon during the period from March 2014 to February 2015 with closed diaphyseal forearm fractures in age group 12–18 years treated with TENS in whom closed reduction could not be achieved. Nail diameter taken as 33-40% of narrowest diameter of diaphysys were introduced proximally in ulna and distally in radius under image intensifier in closed manner. Postoperatively, patients encouraged for active shoulder, elbow and finger movements and suture removal done after 2 weeks. Patients were followed up for minimum period of one year.  </p><p class="abstract"><strong>Results:</strong> In terms of union and range of motion using Anderson et al criteria 24 patients had excellent results, 4 patients had satisfactory results and one patient had poor result having non-union of ulna. Two patients had superficial infection at the nail entry site which eventually resolved. One patient lost for follow up.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that TENS in both bone forearm fractures in adolescent age group in terms of union and range of motion is a minimally invasive and effective method of fixation.</p>

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