scholarly journals Internal fixation of pediatric shaft femur fractures by titanium elastic nails: clinical and radiological study

2016 ◽  
Vol 2 (4) ◽  
pp. 299
Author(s):  
Manoharan M. ◽  
Mahapatra S.
Keyword(s):  
Weight Bearing ◽  
Joint Stiffness ◽  
Femoral Fractures ◽  
Full Weight Bearing ◽  
Age Group ◽  
Femur Fractures ◽  
Pediatric Age Group ◽  
Elastic Nails ◽  
Elastic Nail ◽  
Operative Fixation

<p class="abstract"><strong>Background:</strong> Management of diaphyseal femoral fractures in the pediatric age group is challenging. There has been a demand worldwide for operative fixation<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> Twelve children (7 boys, five girls) aged 6-16 years with diaphyseal femoral fractures (12 fractures, one in each) was stabilized with titanium elastic nail system (TENS). Patients underwent surgery within a week days of their injury. The results were evaluated using Flynn's Scoring system. Identical two nails were used in each fracture.<strong></strong></p><p class="abstract"><strong>Results:</strong> All 12 patients were available for evaluation and follow-up for a mean duration of 24 months (14-34 months). Radiological union in all cases was seen at a mean duration of 8 weeks. Full weight bearing was possible at a mean duration of 10 weeks (8-12 weeks). The results were excellent in 8 patients (67%) and satisfactory in 4 patients (33%).  Complications that occurred were infection (2 cases), knee joint stiffness (4 cases), angulation &lt;10 degrees (1 case), and shortening less than 10 mm (2 cases)<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Intramedullary fixation by TENS is an effective, time-tested treatment of fracture of the femur in patients of the 6-16 years age group<span lang="EN-IN">.</span></p>

Functional outcome of distal femoral fractures managed surgically using locking compression plate laterally and augmented with titanium elastic nail system medially

2021 ◽  
Vol 12 (3) ◽  
pp. 81-87
Author(s):  
Sujay K Mahadik ◽  
Sasha Martyres ◽  
Mrutyunjay S Gaonkar ◽  
Anish W Isapure ◽  
Shrikant B Deshpande
Keyword(s):  
Functional Outcome ◽  
Weight Bearing ◽  
Femoral Fractures ◽  
Locking Compression Plate ◽  
Full Weight Bearing ◽  
Titanium Elastic Nail ◽  
Femur Fractures ◽  
Compression Plate ◽  
Elastic Nail ◽  
The Mean

Background: Distal femur fractures are generally due to high velocity trauma particularly form road traffic accidents and fall from height. The treatment of distal femur fractures has evolved from conservative to operative to fixation of both lateral and medial columns of femur. Aims and Objective:  The aim of this study was to evaluate the functional outcome of operated cases of comminuted fracture of lower end of femur fixed with locking compression plate laterally and augmented with titanium elastic nail system medially. Materials and Methods: The present study was a prospective study carried out in Bharati Vidyapeeth Medical College and Hospital, Sangli after approval from institutional ethical committee. In this study, 20 patients with communited fracture of lower end of femur were included on the basis of a predefined inclusion and exclusion criteria. Detailed history was taken and clinical examination was done in all cases. After preanesthetic evaluation and relevant investigations patients were treated by reduction (close or open) and fixation was done by locking compression plate laterally and augmented with titanium elastic nail system medially. Patients were followed up at 6, 10 and 14 weeks for functional outcome by Neer’s scoring system and degree of flexion at knee joint. Results: Out of 20 studied cases there were 16 (80%) males and 4 (20%) were females with a M:F ratio of 4:1. The mean age of male patients was found to be 42.81+/-14.79 whereas mean age of female patients was 40.5 +/- 14.36. The mean age of male and female patients was found to be comparable with no statistically significant difference (P=0.78). Most of the patient were diagnosed with the fracture of AO TYPE C3 (7 cases), followed by AO TYPE C1 (4 cases). Full weight bearing was achieved in 8 (40%) patients within 18 weeks whereas remaining 12 (60%) patients required more than 20 weeks for full weight bearing. 14 (70%) patients had excellent outcome whereas, Good, Fair and poor outcomes were seen in 4 (20%), 1 (5%) and 1 (5%) patient. On one-way ANOVA analysis, showed that the flexion was significantly higher in 12 weeks as that of the 6 weeks (P =<0.0001). Further the flexion was significantly higher in 24 weeks as that of the 6 and 12 weeks (P =<0.0001). Conclusion: Our study found that locking compression plating laterally augmented with titanium elastic nail system medially for comminuted distal femoral fractures is a good fixation system and provides good angular stability.

scholarly journals Comparison of Titanium Elastic Nailing and End-threaded Intramedullary Pinning for Distal Femoral Fractures in Young Dogs

2021 ◽  
Author(s):  
Harmanpreet Singh Sodhi ◽  
Ashwani Kumar ◽  
Arun Anand ◽  
Vandana Sangwan ◽  
Opinder Singh
Keyword(s):  
Stainless Steel ◽  
Functional Outcome ◽  
Weight Bearing ◽  
Femoral Fractures ◽  
Titanium Implants ◽  
Early Weight Bearing ◽  
Femur Fractures ◽  
Elastic Nails ◽  
Group 2 ◽  
Group 1

Background: Femur fractures are common in immature dogs. As compared to stainless steel, titanium implants are lighter and allow controlled micro-motion at the site of fracture that stimulates early callus formation by limiting stress shielding. Cited literature reports successful clinical use of titanium elastic nails for the stabilization of long bone fractures in young human patients; however, there is paucity of information on this technique is dogs. This study was planned with an objective to compare titanium elastic nails (TENS) and single end-threaded pin for the management of femoral fractures in young dogs. Methods: The study included 20 clinical cases (10 male and 10 female) of dogs suffering from distal femoral fracture with a mean ± SD age of 5.70 ± 5.60 month, body weight 11.09 ± 4.48 Kg since 3.05 ± 2.35 days. The cases were divided into 2 groups; using TENS (n=10; group 1) and stainless steel end-threaded intramedullary pin (n=10; group 2). Result: Group 1 dogs demonstrated better fracture reduction score, early and uniform callus and better implant stability as compared to group 2, radiographically. Early weight bearing and minimum postoperative complications with better functional outcome including joint mobility was reported in group 1. In conclusions, TENS is superior fracture fixation technique for the repair of supracondylar or distal third femur fractures in young dogs with better functional outcome, minimal stiffness of stifle joint and early weight bearing, in comparison to single end threaded intramedullary pin.

ASSESSMENT OF RESULTS OF TREATMENT OF PAEDIATRIC FEMORAL DIAPHYSEAL FRACTURES WITH TITANIUM ELASTIC NAILS

2021 ◽  
pp. 75-76
Author(s):  
Shamir Rahman ◽  
Nafees Fatima ◽  
Vijay Kumar ◽  
Debarshi Jana
Keyword(s):  
Femoral Fractures ◽  
Control Group ◽  
Age Group ◽  
Femur Fractures ◽  
Results Of Treatment ◽  
Operative Evaluation ◽  
Diaphyseal Fractures ◽  
Elastic Nails ◽  
Surgical Modality ◽  
Distal Fracture

Introduction: Femoral fractures are among the most common fractures of long bones. The management of pediatric femur fractures depends basically on the age group of the child although the age of bone and size of the child also determines the treatment choice. The choice of management may also be determined by surgical experience and local trends in practice. Study aimed to assess the results of treatment of paediatric femoral diaphyseal fractures with titanium elastic nails. Material And Methods: The study was conducted at Orthopaedics Department of PMCH, Patna, Bihar. A total of 22 patients with closed shaft femur fractures and age ranging between 5-16 years scheduled to undergo treatment with titanium elastic nails were selected for the study. Children with open fractures, outside this age group with concomitant head injury, bilateral femur fracture or associated fracture of either limb whose xation was done after 7 days were excluded from the study. No control group was used. They were treated by retrograde TENS xation using two nails of equal diameter for each fracture. Pre-operative evaluation includes full length radiograph of the fractured femur both antero–posterior (A–P) and lateral views. Results: In the present study, 22 patients with closed shaft femur fractures were treated with titanium elastic nails. The mean age of the patient was 13.23 years. We observed that in regards to fracture location, proximal fracture was seen in 5 patients, midshaft fracture in 14 patients and distal fracture in 3 patients. However, in regards to pattern of location, transverse fracture was seen in 6 patients, oblique fracture in 8 patients, spiral fracture in 5 patients and comminuted fracture in 3 patients. Conclusion: From this study we can conclude that Intramedullary nailing of the pediatric femoral diaphyseal fractures using titanium elastic nail is an effective surgical modality, with advantages of minimal incisional scar, minimal soft tissue damage, with early union time and excellent union rates, and without affecting shoulder and elbow function.

scholarly journals Radiologic and functional outcome in patients with ipsilateral fractures of proximal femur and shaft treated by long proximal femoral nailing

2020 ◽  
Vol 7 (1) ◽  
pp. 129
Author(s):  
Saju S. ◽  
Thomas M. A.
Keyword(s):  
Functional Outcome ◽  
Proximal Femur ◽  
Weight Bearing ◽  
Femoral Fractures ◽  
Full Weight Bearing ◽  
Femoral Nailing ◽  
Femur Fractures ◽  
The Mean ◽  
Mean Time ◽  
Proximal Femoral Nailing

<p class="abstract"><strong>Background:</strong> Combination of ipsilateral proximal femur and shaft of femur fractures are one of the rare fractures which were previously managed with two different implants for each fracture. Various studies have shown that long proximal femoral nailing is as effective as two different implants in fracture healing.</p><p class="abstract"><strong>Methods:</strong> 25 cases in the age group of 20-80 years with ipsilateral proximal femur and shaft of femur fractures were enrolled from July 2014 to July 2017 and treated with long proximal femoral nailing. The cases were followed up at 6 weekly intervals and were assessed for their functional outcome using Friedman and Wyman criteria.</p><p class="abstract"><strong>Results: </strong>Proximal femoral fractures united at an average time of 3.96 ±1.3 months, whereas the mean time shaft of femur fractures took to unite was 5.67±3 months. The mean time patients took to start full weight bearing was 6.15±2.76 months. Functional assessment at 12 months revealed outcome as good in18 (75%), fair in 5 (20.8%) and poor in 1 (4.1%).</p><p class="abstract"><strong>Conclusions:</strong> Long proximal femoral nailing is a good option in managing patients with ipsilateral proximal and shaft of femur fractures.</p>

scholarly journals TENS for the surgical management of femoral shaft fractures in 6-14 years age group children

2017 ◽  
Vol 5 (2) ◽  
pp. 13-21
Author(s):  
Mohit Khanna ◽  
Jitendra Wadhwani ◽  
Amit Batra ◽  
Sidharth Yadav ◽  
Sarfraz Iman ◽  
...  
Keyword(s):  
Prospective Study ◽  
Weight Bearing ◽  
Femoral Shaft ◽  
Full Weight Bearing ◽  
External Fixators ◽  
Age Group ◽  
Femoral Shaft Fractures ◽  
Femur Fractures ◽  
Shaft Fractures ◽  
Fractures In Children

Background. Fracture shaft of femur in pediatric age group is one of the most common leading emergencies. Children in the age group of 6-14 years are treated with either traction, hip spica, flexible/elastic stable retrograde intramedullary nail, or external fixators. We conducted a clinical prospective study on the use of Titanium Elastic Nailing System (TENS) for the treatment of femoral shaft fractures in children. Methods. The prospective study included 45 cases of fresh femoral shaft fractures. The Inclusion Criteria were a) Age group of 6-14 years, b) Recent fracture of femur shaft c) Transverse, short oblique, minimally comminuted fractures. Results. The clinical results were evaluated using Flynn’s criteria of scoring as, Excellent in 40 patients (88.89 %), Satisfactory in 5 patients (11.12 %) and poor in none. Radiological criteria for fracture union were assessed by using Anthony et al scale. Nine patients developed bursitis at entry point of the nail. Three patients had superficial infection due to bursitis. Full weight bearing was possible in mean time of 8.7 weeks (range; 7-12 weeks). Conclusion. TENS is very effective in management of paediatric shaft femur fractures in the age group of 6-14 years with advantages of early union, early mobilization and manageable complications.

scholarly journals Locking condylar plate: best device to treat supracondylar fractures of the femur

2019 ◽  
Vol 5 (3) ◽  
pp. 393
Author(s):  
Irwant V. Pallewad ◽  
Vijay B. Kagne ◽  
Jayshree J. Upadhye
Keyword(s):  
Fracture Fixation ◽  
Distal Femur ◽  
Road Traffic ◽  
Weight Bearing ◽  
Femoral Fractures ◽  
Research Centre ◽  
Full Weight Bearing ◽  
Supracondylar Fractures ◽  
Femur Fractures ◽  
Fractures Of The Femur

<p class="abstract"><strong>Background:</strong> Supracondylar fractures of the femur in adults account for only 7% of all femoral fractures. However, these fractures present with numerous complications. The purpose of this study was to assess the outcome of locking condylar plate in supracondylar fractures of femur in adults.</p><p class="abstract"><strong>Methods:</strong> This study was based on 25 patients of supracondylar fracture of the femur treated with locking condylar plate at Srinivas Institute of Medical Sciences and Research Centre, Mukka, Suratkal, Mangalore. The patients were followed up for 1 year.<strong></strong></p><p class="abstract"><strong>Results:</strong> In present study, 84% fractures were sustained due to road traffic accidents. In 23 (92%) patients, full weight bearing was achieved at 20 weeks while only 2 (8%) patients required more than 20 weeks. 80% of cases required less than 16 weeks for union while 20% required more than 16 weeks. Average injury to surgery time was 3.62 days in the present series. Superficial stitch infection occurred in two cases. Deep infection occurred in a grade 2 compound fracture in a male who was treated initially with debridement and antibiotics.</p><p><strong>Conclusions:</strong> Good results are seen by distal femur locking condylar plate alone. It is the main implant of choice for distal femur fractures of all varieties. Best outcome is expected if fracture fixation is done following all the basic principles of fracture fixation. Advantage of the mechanical properties of a locking plate is definitely useful. </p>

scholarly journals A review of pediatric femoral fracture patterns, surgical managements, and outcomes

2021 ◽  
Vol 7 (6) ◽  
pp. 1080
Author(s):  
Ahmad K. Almigdad ◽  
Khalid A. Banimelhem ◽  
Ghandi K. Almanasir ◽  
Ehab M. Altaani ◽  
Ala K. Al-Qudah
Keyword(s):  
Femoral Fracture ◽  
Weight Bearing ◽  
Femoral Fractures ◽  
Military Hospital ◽  
Full Weight Bearing ◽  
Accidental Injury ◽  
Extrinsic Factors ◽  
Femur Fractures ◽  
Pediatric Femur Fracture ◽  
Pediatric Femoral Fracture

<p class="abstract"><strong>Background: </strong>Femoral fractures are the most common pediatric orthopedic fractures that require hospitalization. The non-accidental injury should be suspected in early infancy and non-ambulatory children. Treatment of pediatric femoral fractures is widely variable and depends on intrinsic and extrinsic factors. This study presents pediatric femoral fracture epidemiology and outcomes and reviews the literature regarding best practices in pediatric femoral fractures.</p><p class="abstract"><strong>Methods:</strong> This retrospective study reviewed the clinical and radiological records of forty-sevens femur fractures in the pediatric age group from September 2020 until June 2021 in Prince Rashid bin AL Hassan Military Hospital in Jordan.</p><p class="abstract"><strong>Results:</strong> Males form 80.9% of patients. The mean age for the patients was equal to 6.70 years (±3.91). Falling is responsible for the majority of the injury. The middle femur shaft was fractured in 46.8%, and the pathological fracture was found in 17% of patients. Non-operative treatment by cast represents 42.6%. All fractures were healed at 7.90 weeks (±2.37).</p><p class="abstract"><strong>Conclusions: </strong>Pediatric femur fracture lacks standardized treatment. Nevertheless, most fractures healed with satisfactory results. Younger age groups are more likely to be treated non-operatively. Non-surgical treatment is more prone to shortening, angulation, and later return to weight-bearing and activity. Children older than eight years treated by plating demonstrated faster healing, return to full weight-bearing, and lower complication rate.  </p>

scholarly journals Management of fracture shaft of femur in children with Titanium Elastic Nailing (TEN) at Dhaka Medical College Hospital, Bangladesh

2015 ◽  
Vol 23 (1) ◽  
pp. 24-30
Author(s):  
Md Mobarak Hossain ◽  
Quazi Shahidul Alam ◽  
E Haque ◽  
MS Rahman
Keyword(s):  
Weight Bearing ◽  
Full Weight Bearing ◽  
Group Method ◽  
Age Group ◽  
Titanium Elastic Nail ◽  
Medical College ◽  
Fractures In Children ◽  
Diaphyseal Fractures ◽  
Elastic Nail ◽  
Mean Time

Context: Management of femoral diaphyseal fractures in children with ages 5 to 15 years is controversial. There has been debate of operative fixation worldwide. Objective: To evaluate the outcome of Titanium Elastic Nail (TEN) for the treatment of fracture of shaft of femur in pediatric age group. Method: Ten children aged 5-15 years with femoral diaphyseal fractures were stabilized with Titanium Elastic Nail (TEN). The results were evaluated using Flynn’s Scoring Criteria. Two nails were used in each fracture. Radiological union in all cases was achieved in a mean time of 8 weeks. Full weight bearing was possible in a mean time of 06 weeks. Result: The results were excellent in 10 patients (100%). Intramedullary fixation by TEN is an effective treatment of fracture of femur in properly selected patients of the 5-15 years age group. Conclusion: Treatment of femoral shaft fracture in children aged 5-15years by TEN is ideal, as it hastens fracture union, reduce the rate of mal union, shortening and allow early rehabilitation. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22689 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 24-30

scholarly journals Finite element analysis of double‐plate fixation using reversed locking compression‐distal femoral plates for Vancouver B1 periprosthetic femoral fractures

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Daisuke Takahashi ◽  
Yoshihiro Noyama ◽  
Tsuyoshi Asano ◽  
Tomohiro Shimizu ◽  
Tohru Irie ◽  
...  
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Plate Fixation ◽  
Weight Bearing ◽  
Femoral Fractures ◽  
Full Weight Bearing ◽  
Loading Test ◽  
Lateral Plate ◽  
Element Analysis ◽  
Periprosthetic Femoral Fractures

Abstract Background Internal fixation is recommended for treating Vancouver B1 periprosthetic femoral fractures. Although several fixation procedures have been developed with high fixation stability and union rates, long-term weight-bearing constructs are still lacking. Therefore, the aim of the present study was to evaluate the stability of a double-plate procedure using reversed contralateral locking compression-distal femoral plates for fixation of Vancouver B1 periprosthetic femoral fractures under full weight-bearing. Methods Single- and double-plate fixation procedures for locking compression-distal femoral plates were analysed under an axial load of 1,500 N by finite element analysis and biomechanical loading tests. A vertical loading test was performed to the prosthetic head, and the displacements and strains were calculated based on load-displacement and load-strain curves generated by the static compression tests. Results The finite element analysis revealed that double-plate fixation significantly reduced stress concentration at the lateral plate place on the fracture site. Under full weight-bearing, the maximum von Mises stress in the lateral plate was 268 MPa. On the other hand, the maximum stress in the single-plating method occurred at the defect level of the femur with a maximum stress value of 1,303 MPa. The principal strains of single- and double-plate fixation were 0.63 % and 0.058 %, respectively. Consistently, in the axial loading test, the strain values at a 1,500 N loading of the single- and double-plate fixation methods were 1,274.60 ± 11.53 and 317.33 ± 8.03 (× 10− 6), respectively. Conclusions The present study suggests that dual-plate fixation with reversed locking compression-distal femoral plates may be an excellent treatment procedure for patients with Vancouver B1 fractures, allowing for full weight-bearing in the early postoperative period.

Sign in / Sign up

Export Citation Format

Share Document