scholarly journals Flexible intramedullary nails with traction versus plaster cast for treating femoral shaft fractures in children: comparative retrospective study

2013 ◽  
Vol 131 (1) ◽  
pp. 5-12 ◽  
Author(s):  
Fabiano Prata do Nascimento ◽  
Cláudio Santili ◽  
Miguel Akkari ◽  
Gilberto Waisberg ◽  
Susana dos Reis Braga ◽  
...  
Keyword(s):  
Weight Bearing ◽  
Femoral Shaft ◽  
Plaster Cast ◽  
Intramedullary Nails ◽  
Femoral Shaft Fractures ◽  
Conservative Group ◽  
Shaft Fractures ◽  
Partial Weight ◽  
Plaster Casts ◽  
Surgical Group

CONTEXT AND OBJECTIVEFemoral fractures are common in children between 2 and 12 years of age, and 75% of the lesions affect the femoral shaft. Traction followed by a plaster cast is universally accepted as conservative treatment. However, in some situations, a surgical approach is recommended. The objective here was to compare treatments for femoral shaft fractures using intramedullary nails (titanium elastic nails, TEN) versus traction and plaster casts in children. The hypothesis was that TEN might provide better treatment, with good clinical results in comparison with plaster casts.DESIGN AND SETTINGThis retrospective comparative study was conducted in a public university hospital.METHODSSixty children with femoral fractures were evaluated; 30 of them underwent surgical treatment with TEN and 30 were treated conservatively using plaster casts. The patients' ages ranged from 5 to 13 years (mean of 9 years).RESULTSThe mean duration of hospitalization was nine days for the surgical group and 20 days for the conservative group. The incidence of overgrowth in the patients treated with TEN was 60.0% and, for those treated conservatively, 13.3%. Partial weight-bearing was allowed after 3.5 weeks in the surgical group and after 9.6 weeks in the conservative group. New hospitalization was required for 90.0% in the surgical group and 16.7% in the conservative group. Patients treated with plaster casts presented higher incidence of complications, such as loss of reduction.CONCLUSIONSThe surgical method presented better results for children.

scholarly journals A prospective study of retrograde nailing for distal third femoral shaft fractures

2021 ◽  
Vol 7 (5) ◽  
pp. 1021
Author(s):  
Nikil Sanaba Paramesh ◽  
Pradeep Kumar Munirathnaiah
Keyword(s):  
Weight Bearing ◽  
Femoral Shaft ◽  
Consecutive Series ◽  
Retrograde Nailing ◽  
Partial Weight Bearing ◽  
Significant Deterioration ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures ◽  
Canal Diameter ◽  
Partial Weight

<p><strong>Background: </strong>To evaluate the postoperative knee range of motion and results of unreamed retrograde nailing for distal third femoral shaft fractures.</p><p><strong>Methods: </strong>Between June 2019 and June 2021 inclusive, a consecutive series of 20 patients who underwent retrograde nailing were prospectively evaluated. Outcome measures were union time, initiation of weight bearing, deformity and shortening, functional length of the nail, knee function assessed using a modified knee society knee score. Correlations between union time and other variables were also studied.</p><p><strong>Results: </strong>In these patients 18 (90%) of the 20 fractures achieved union, of which 4 underwent dynamisation; the mean union time for the other 18 fractures was 3.1 months. Angular malalignment was present in 2 patients and shortening in 3 others. There was negligible correlation between union time and variables of nail-canal diameter mismatch, functional length of nail, fracture geometry, or initiation of partial weight bearing ambulation. Knee flexion of more than 100 degrees was achieved in 19 patients. 14 patients had anterior knee pain and 7 had instability in early phases of ambulation. By the end of one year, excellent or good scores for pain and function were recorded in 95% and 86% respectively of the 20 patients.</p><p><strong>Conclusions: </strong>In view of such favourable union rates and no significant deterioration in overall knee joint function, at best retrograde nailing is a reliable alternative in the management of selected complicated fractures of the distal femoral shaft.</p>

Failure of Exchange Reamed Intramedullary Nails for Ununited Femoral Shaft Fractures

2000 ◽  
Vol 14 (5) ◽  
pp. 335-338 ◽  
Author(s):  
Matthew J. Weresh ◽  
Robyn Hakanson ◽  
Michael D. Stover ◽  
Stephen H. Sims ◽  
James F. Kellam ◽  
...  
Keyword(s):  
Femoral Shaft ◽  
Intramedullary Nails ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures

Femoral-shaft fractures and nonunions treated with intramedullary nails: The role of dynamisation

Injury ◽  
2011 ◽  
Vol 42 (11) ◽  
pp. 1353-1361 ◽  
Author(s):  
Costas Papakostidis ◽  
Ioannis Psyllakis ◽  
Demetrios Vardakas ◽  
Anastasios Grestas ◽  
Peter V. Giannoudis
Keyword(s):  
Femoral Shaft ◽  
Intramedullary Nails ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures

scholarly journals Role of Open Cerclage Wires Used in Patients with Comminuted Fractures of Femoral Shaft Treated with Intramedullary Nails

2020 ◽  
Author(s):  
Tzu-Hao Wang ◽  
Hao-Chun Chuang ◽  
Fa-Chuan Kuan ◽  
Chih-Kai Hong ◽  
Ming-Long Yeh ◽  
...  
Keyword(s):  
Femoral Shaft Fracture ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
Fracture Treatment ◽  
Union Rate ◽  
Intramedullary Nails ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures ◽  
Significant Difference ◽  
Cerclage Wiring

Abstract IntroductionThe role of open cerclage wiring in comminuted femoral shaft fracture treatment with intramedullary nails remains unclear. Here, we analyzed the effect of open cerclage wiring and the risk factors for nonunion after interlocking nailing in comminuted femoral shaft fracture treatment. We hypothesize that open cerclage wiring is applicable to patients with severe comminuted femoral shaft fractures without affecting bone healing.Patients and MethodsThis retrospective cohort study used data of consecutive patients who underwent interlocking nail fixation of a comminuted femoral shaft fracture between January 1, 2009, and December 31, 2016. First, eligible patients were divided into wire and no wire groups according to the surgical technique used and their union rate was recorded. The patients were then divided into union and nonunion groups and their perioperative data were analyzed.ResultsIn total, 71 comminuted femoral shaft fractures treated with interlocking nail fixation were included: 38 fractures (53.5%) augmented with the open wiring technique and 33 reduced with closed or mini–open wound without wiring. The wire group demonstrated significant improvements in fracture reduction compared with the no wire group, whereas no significant difference was observed in the union rate between the wire and no wire groups (p = 0.180). Moreover, 46 (65%) of 71 fractures united smoothly, and no significant difference was observed in any perioperative data between union and nonunion groups.DiscussionAugmented open cerclage wiring is indicated for comminuted femoral shaft fractures treated with intramedullary nails, even when the fragments are large or far displaced. Thus, open cerclage wiring can be used for fracture treatment, without decreasing the union rate.

scholarly journals Ipsilateral hip and femoral shaft fractures treated with intramedullary nails

2006 ◽  
Vol 31 (1) ◽  
pp. 77-81 ◽  
Author(s):  
M. Shantharam Shetty ◽  
M. Ajith Kumar ◽  
Sandeep S. Ireshanavar ◽  
Dr Sudhakar
Keyword(s):  
Femoral Shaft ◽  
Intramedullary Nails ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures
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