Treatment of femoral fractures in children aged two to six

2020 ◽  
Vol 102-B (8) ◽  
pp. 1056-1061 ◽  
Author(s):  
J. Eric Gordon ◽  
John T. Anderson ◽  
Perry L. Schoenecker ◽  
Matthew B. Dobbs ◽  
Scott J. Luhmann ◽  
...  
Keyword(s):  
Intramedullary Nailing ◽  
Femoral Fractures ◽  
Age Group ◽  
Spica Casting ◽  
Flexible Intramedullary Nailing ◽  
Fractures In Children ◽  
Significant Difference ◽  
The Family ◽  
Intramedullary Stabilization ◽  
The Mean

Aims Current American Academy of Orthopaedic Surgeons (AAOS) guidelines for treating femoral fractures in children aged two to six years recommend early spica casting although some individuals have recommended intramedullary stabilization in this age group. The purpose of this study was to compare the treatment and family burden of care of spica casting and flexible intramedullary nailing in this age group. Methods Patients aged two to six years old with acute, non-pathological femur fractures were prospectively enrolled at one of three tertiary children’s hospitals. Either early closed reduction with spica cast application or flexible intramedullary nailing was accomplished under general anaesthesia. The treatment method was selected after discussion of the options by the surgeon with the family. Data were prospectively collected on patient demographics, fracture characteristics, complications, pain medication, and union. The Impact on Family Scale was obtained at the six-week follow-up visit. In all, 75 patients were included in the study: 39 in the spica group and 36 in the nailing group. The mean age of the spica group was 2.71 (2.0 to 6.9) years and the mean age of the nailing group was 3.16 (2.0 to 6.9) years. Results All fractures healed without evidence of malunion or more than 2.0 cm of shortening. The mean Impact on Family score was 70.2 for the spica group and 63.2 (55 to 99) for the nailing group, a statistically significant difference (p = 0.024) in a univariate analysis suggesting less impairment of the family in the intramedullary nailing group. There was no significant difference between pain medication requirements in the first 24 hours postoperatively. Two patients in the spica group and one patient in the intramedullary nailing group required additional treatment under anaesthesia. Conclusion Both early spica casting and intramedullary nailing were effective methods for treating femoral fractures in children two to six years of age. Intramedullary stabilization provides an option in this age group that may be advantageous in some social situations that depend on the child’s mobility. Fracture treatment should be individualized based on factors that extend beyond anatomical and biological factors. Cite this article: Bone Joint J 2020;102-B(8):1056–1061.

scholarly journals Functional and radiological outcome after closed reduction and percutaneous pinning versus open reduction and internal fixation in displaced supracondylar fractures in children

2016 ◽  
Vol 19 (2) ◽  
pp. 21-27 ◽  
Author(s):  
Amin Kumar Shrestha ◽  
Suresh Uprety ◽  
Govinda K.C. ◽  
Sharma Paudel
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Supracondylar Fracture ◽  
Age Group ◽  
Radiological Outcome ◽  
Percutaneous Pinning ◽  
Supracondylar Fractures ◽  
Fractures In Children ◽  
Significant Difference ◽  
The Mean

Introduction: Supracondylar fracture of humerus is very common fracture in pediatric age group. The current trends of management in displaced type are close reduction and per cutaneous pinning (CRPP), if reduction is not satisfactory then open reduction and internal fixation (ORIF) is done.  Our study aims to compare the cosmetic, functional and radiological outcome between these two methods. Methodology: Children with displaced extension type supracondylar fracture of distal humerus presenting to emergency room and orthopedics OPD who could meet the inclusion criteria were taken up for study. Sixty-three such patients (37 CRPP and 26 ORIF) were included in the study. Radiological and functional outcomes were followed up at 8 weeks post-operatively. Results: Of the 63 patients enrolled, 26 (41.3%) patients had undergone open reduction and internal fixation and 37 (58/7%) had undergone close reduction and percutaneous pinning. The mean age of patients in CRPP and ORIF groups was 7.29±2.3 years and 8.11±2.02 years respectively. Maximum patients were from age group 7-9 years (46%). Left side was more commonly injured (66.7% vs. 33.3%) (P = 0.045). According to the Flynn’s criteria, cosmetically the outcome did not differ between the two surgical groups (P = 0.23). However, CRPP proved to have a significantly better functional outcome (P=0.000). The mean Bauman’s angle in CRPP and ORIF groups was 16.89±5.66 and 18.88±4.90 degrees respectively. However, there is no statistically significant difference between the type of fixation and Bauman’s angle or Anterior humeral line. Conclusions: Close reduction and percutaneous pinning (CRPP) has better functional and radiological outcome in comparison with open reduction and internal fixation (ORIF) in displaced supracondylar fracture of humerus in children.

scholarly journals Randomized Controlled Trial of the Clinical Recovery and Biodegradation of Polylactide-co-glycolide Implants Used in the Intramedullary Nailing of Children’s Forearm Shaft Fractures with at Least Four Years of Follow-Up

2021 ◽  
Vol 10 (5) ◽  
pp. 995
Author(s):  
Marja Perhomaa ◽  
Tytti Pokka ◽  
Linda Korhonen ◽  
Antti Kyrö ◽  
Jaakko Niinimäki ◽  
...  
Keyword(s):  
Intramedullary Nailing ◽  
Controlled Trial ◽  
Long Term Outcomes ◽  
Intramedullary Nails ◽  
Metal Implants ◽  
Shaft Fractures ◽  
Fractures In Children ◽  
Significant Difference

The preferred surgical fixation of forearm shaft fractures in children is Elastic Stable Intramedullary Nailing (ESIN). Due to known disadvantageous effects of metal implants, a new surgical method using biodegradable polylactide-co-glycolide (PLGA) intramedullary nails has been developed but its long-term outcomes are unclear. The aim of this study was to compare the long-term outcomes of Biodegradable Intramedullary Nailing (BIN) to ESIN and assess the biodegradation of the study implants via magnetic resonance imaging (MRI). The study population of the prospective, randomized trial consisted of paediatric patients whose forearm shaft fractures were treated with BIN (n = 19) or ESIN (n = 16). Forearm rotation at minimally four years’ follow-up was the main outcome. There was no clinically significant difference in the recovery of the patients treated with the BIN as compared to those treated with the ESIN. More than half of the implants (57.7%, n = 15/26) were completely degraded, and the rest were degraded almost completely. The PLGA intramedullary nails used in the treatment of forearm shaft fractures in this study resulted in good function and anatomy. No unexpected disadvantages were found in the degradation of the implants. However, two implant failures had occurred in three months postoperatively.

Skin traction in hip spica casting for femoral fractures in children

2007 ◽  
Vol 12 (4) ◽  
pp. 327-333 ◽  
Author(s):  
Cem Zeki Esenyel ◽  
Kahraman Öztürk ◽  
Oktay Adanir ◽  
Bulent Aksoy ◽  
Meltem Esenyel ◽  
...  
Keyword(s):  
Femoral Fractures ◽  
Spica Casting ◽  
Fractures In Children ◽  
Skin Traction

scholarly journals Flexible Intramedullary Nailing of Pediatric Femoral Fractures

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Joshua S. Murphy ◽  
Ryan Koehler ◽  
Megan Johnson ◽  
Pooya Hosseinzadeh
Keyword(s):  
Intramedullary Nailing ◽  
Femoral Fractures ◽  
Flexible Intramedullary Nailing

OBSERVATIONS OF TOTAL SERUM BASE IN CHILDREN AND YOUNG ADULTS BY A CONDUCTIVITY METHOD

PEDIATRICS ◽  
1949 ◽  
Vol 4 (6) ◽  
pp. 805-809
Author(s):  
W. M. KELSEY ◽  
L. B. LEINBACH
Keyword(s):  
Young Adults ◽  
Total Serum ◽  
Age Group ◽  
Conductivity Method ◽  
Normal Children ◽  
Significant Difference ◽  
Children And Young Adults ◽  
The Mean ◽  
Standard Deviations

Values for total serum base in 96 normal children under 12 years of age as determined by the conductivity method fell between 143 to 160.5 mEq./l. The mean was 153. Standard deviations for each age group are given. The values in 73 normal persons above the age of 12 varied from 142 to 160.5 mEq./l. The mean was 147 mEq./l. A statistically significant difference between the total serum base in children and adults was found.

scholarly journals TIME TRENDS OF HELICOBACTER PYLORI PREVALENCE IN ITAJAÍ - SC: A RETROSPECTIVE STUDY OF 25 YEARS BASED ON ENDOSCOPIC DATABASE

2019 ◽  
Vol 56 (1) ◽  
pp. 10-14 ◽  
Author(s):  
Fangio FERRARI ◽  
Elisa Cantú Germano DUTRA ◽  
Henrieli Correia ZANARDI ◽  
Bruno Lorenzo SCOLARO ◽  
Odemari Miranda FERRARI
Keyword(s):  
Helicobacter Pylori ◽  
Age Groups ◽  
Developed Countries ◽  
Helicobacter Pylori Infection ◽  
Age Group ◽  
Gradual Reduction ◽  
Urease Test ◽  
Significant Difference ◽  
The Mean ◽  
And Gender

ABSTRACT BACKGROUND: The bacterium Helicobacter pylori is strongly associated with the development of gastric adenocarcinoma. Currently, the prevalence in developed countries is 40%, but this value increases considerably in developing countries, which can reach rates bigger than 90%. OBJECTIVE: The objective of this study was to determine the mean and annual prevalence of Helicobacter pylori infection in patients from Itajaí during the period from July 1992 to April 2016, as well as the gender and age groups most affected. METHODS: After consent of the clinical director of the Gastroclinica Itajaí and confidentiality commitment about the research, the database of the Endoscopy Service of the clinic was evaluated. All the patients who underwent their first upper digestive endoscopy with urease test and/or histological analysis were included. The data were submitted to statistical analysis of prevalence by gender, age group and years of study, with subsequent correction through the confidence interval. RESULTS: The mean prevalence of Helicobacter pylori infection thru all years of study was 50.07%. With the calculation of the annual prevalences, it was evident the gradual reduction of infection in the population of Itajaí, that was 81.3% in 1992, declining to 33% in the year of 2016. When classifying the prevalence of infection by gender, it was higher in males (53.59%), and gender distribution by age group showed no statistically significant difference among genders between the ages of 40 and 80 years. In relation to the age group, the highest prevalence was in the group between 40 and 49 years. CONCLUSION: Although this study is retrospective and based on endoscopic database analysis, without access to clinical data of patients such as prior use of proton pump inhibitor and antibiotics to endoscopy, its results are important because they may reflect the current panorama of Helicobacter pylori infection in the city under study, where it has been presenting a gradual reduction of prevalence over the years, with current rates similar to that of developed countries (33%). Future studies are needed to confirm our data.

A study of manual toothbrushing skills in children aged 3 to 11 years

2003 ◽  
Vol 27 (1) ◽  
pp. 91-94 ◽  
Author(s):  
Ali Mentes ◽  
Julide Atukeren
Keyword(s):  
Age Groups ◽  
Age Group ◽  
Age And Gender ◽  
Significant Difference ◽  
Study Population ◽  
The Mean ◽  
And Gender

The aim of the study was to evaluate toothbrushing management and ability of children in relation to age and gender. The study population consisted of 75 children and were divided into three equal groups as 3-5, 6-8 and 9-11 years of age.The grip type during toothbrushing was recorded on videotape.The most preferred grip types were distal (73%) followed by power (43%) and oblique grips (29%). There were a statistically significant differences between age groups and the grip types (p<0.001) but no significant difference was seen between boys and girls in grip preferences (p>0.05).The mean duration of toothbrushing was shorter in 3-5 years of age group (28 seconds) than the 6-8 and 9-11 age groups (35 and 47 seconds respectively).

scholarly journals Influence of sex and age on sonographic infant hip indices

2014 ◽  
Vol 2 (4) ◽  
Author(s):  
Kakale SB ◽  
Tabari AM ◽  
Isyaku K ◽  
Yunusa A
Keyword(s):  
Imaging Modality ◽  
Alpha Angle ◽  
Late Presentation ◽  
Radiology Department ◽  
Age Group ◽  
Hip Joints ◽  
Non Invasive ◽  
Significant Difference ◽  
Males And Females ◽  
The Mean

Ultrasound is a non-invasive, cheap and readily available imaging modality for studying the infant hip. Early detection of developmental hip subluxation, acetabular dysplasia and the prevention of late presentation of a developmentally dislocated hip with consequent secondary premature degenerative arthritis are goals that all practitioners should strive for. Provision of axial indices of alpha and beta angles of the infant hip joint in Kano, Nigeria using ultrasonography to establish a normogram as reference values for further studies is the objective of this study. This descriptive prospective study was conducted at the Radiology Department of Aminu Kano Teaching Hospital, Kano state, Nigeria. Successive four hundred appropriately consented infants were recruited for this study. The axial angle relationships of both hip joints were measured using 7.5 MHz linear transducer of Mindray DP-8800 Digital plus ultrasound machine. The mean alpha and beta angles for both hips in females were 56.590 and 49.580 respectively while those for males were 56.730 and 50.530 respectively. Minimum and maximum alpha angle for both hips ranged from 380 to 780 while the beta angles ranged 290 to 660 respectively. The age group 1-3 months has the highest frequency of respondents (251) while age group 10 - 12 months has the lowest (22). There was no statistically significant difference in the alpha and beta angles between males and females hips and age of the infants did not affect the hip indices. The study showed no statistical significant difference in the measured alpha and beta angles between males and females. Age of measurement in infants did not affect the hip indices.

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