scholarly journals Elastic stable intramedullary nailing in pediatric diaphyseal forearm bone fracture

2017 ◽  
Vol 3 (2) ◽  
pp. 190
Author(s):  
Poojan Kumar Rokaya ◽  
Mangal Rawal ◽  
Javed Ahmad Khan ◽  
Praveen Kumar Giri
Keyword(s):  
Intramedullary Nailing ◽  
Bone Fracture ◽  
Closed Reduction ◽  
Forearm Fracture ◽  
Minimal Invasive ◽  
Elastic Stable Intramedullary Nailing ◽  
Forearm Bones ◽  
Average Loss ◽  
Forearm Bone ◽  
Elastic Intramedullary Nailing

<p class="abstract"><strong>Background:</strong> Pediatric forearm bone fracture present significant challenges where most of them are managed with closed reduction and casting. Irreducible, unstable and open fracture usually requires operative stabilization. Intramedullary nailing is considered minimal invasive however it is not free of complication. The aim of this study is to analyze the outcome and complications after elastic stable intramedullary nailing in pediatric diaphyseal forearm fracture<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> A descriptive observational study was carried out for four years (2013-2016) in diaphyseal pediatric forearm fracture stabilized with titanium elastic stable intramedullary nailing. Final range of motion, complications and outcome were assessed using Clavien-Dindo classification modification appropriate for orthopedic surgery.<strong></strong></p><p class="abstract"><strong>Results:</strong> We report the outcome of 36 patients with complete medical records. Closed reduction and nailing was successful in 25 patients (69.4%) whereas eleven patients (30.6%) required open reduction (both radius and ulna in 6 patients 16.7%, ulna in 3 patients 8.3% and radius in 2 patients 5.6%). Radiological union was achieved at an average of 7.75±1.5 weeks (range 6 to 16 weeks). Forearm rotation was limited in 7 patients with average loss of 16° pronation and 18° supination. The overall rate of complication was 22.2%. According to Clavien-Dindo classification excellent results were noted in 29 patients (80.6%), good in 3 patients (8.3%) and fair in 4 patients (11.1%)<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Elastic intramedullary nailing in pediatric diaphyseal forearm bones fracture is minimally invasive with low rate of complication and the outcomes are fair to excellent<span lang="EN-IN">.</span></p>

scholarly journals Intramedullary Nailing for Paediatric Diaphyseal Forearm Bone Fracture

2012 ◽  
Vol 9 (3) ◽  
pp. 198-202 ◽  
Author(s):  
N P Parajuli ◽  
D Shrestha ◽  
D Dhoju ◽  
G R Dhakal ◽  
R Shrestha ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Bone Fracture ◽  
Closed Reduction ◽  
Open Reduction ◽  
Forearm Fracture ◽  
Skin Irritation ◽  
Pediatric Age Group ◽  
Superficial Skin ◽  
Reduction Methods ◽  
Forearm Bone

Background Though most of the pediatric diaphyseal forearm bone fracture can be treated with closed reduction and cast application, indications for operative intervention in pediatric both-bone forearm fractures include open fractures, irreducible fractures, and unstable fractures. Controversy exists as to what amount of angulation, displacement, and rotation constitutes an acceptable reduction. Objective To review union time and functional outcome of pediatric diaphyseal forearm bone fracture managed with intramedullary rush pin by closed or open reduction. Methods Fifty patients with both bone fracture of forearm were treated with intramedullary rush pin by closed or open reduction were included in the study and followed up for minimum six months for radilological and functional outcome. Results Out of 50 patients, 31 underwent closed reduction and 19 underwent open reduction. All fractures maintained good alignment post operatively. Forty seven patients had excellent results with normal elbow range of motion and normal forearm rotation and three patients had good results. In all patients good radiological union was seen in three months time. Eight patients had minor complications including skin irritation over prominent hardware, backing out of ulnar pin, superficial skin break down with exposed hardware. Twenty-three (46%) patients had undergone implant removal at an average of 6 months (range 4-8 months) under regional or general anesthesia Conclusion Fixation with intramedullary rush pin for forearm fracture is an effective, simple, cheap, and convenient way for treatment in pediatric age group. DOI: http://dx.doi.org/10.3126/kumj.v9i3.6305 Kathmandu Univ Med J 2011;9(3):198-202 

scholarly journals Antegrade elastic stable intramedullary nailing in treatment of irreducible distal radius fractures in diaphyseal-metaphyseal junction in children

2020 ◽  
Author(s):  
Weifeng Lin ◽  
Shuai Liu ◽  
Taotao Hui
Keyword(s):  
Intramedullary Nailing ◽  
Distal Radius ◽  
Closed Reduction ◽  
Statistical Significance ◽  
Minimal Invasive ◽  
Elastic Stable Intramedullary Nailing ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Fractures In Children

Abstract Purpose This paper aimed to study the method and outcome of antegrade elastic stable intramedullary nailing (ESIN) for irreducible distal radius fractures in diaphyseal-metaphyseal junction in children. Methods 27 irreducible distal radius fractures in children ranging in age from six to 13 years treated with closed reduction and antegrade ESIN from March 2017 to September 2018 were analyzed retrospectively. The series comprised 24 boys and three girls. 17 cases were double fractures in forearms and ten cases were single fractures of radius. Each case was treated with closed reduction, internal fixation of antegrade ESIN and plaster cast. ESIN was removed when fracture healed and remodelled well. Cooney modified Green-O'Brien wrist score was used to evaluate the wrist function. Ranges of motion (ROM) in bilateral wrists were contrasted at the final follow-up. P<0.05 was considered statistically significant in the difference. Results All the fractures healed four to six weeks post-operative. At the final follow-up (12-16 months), there was no statistical significance in ROM of bilateral wrists (all p>0.05). The mean Cooney modified Green-O'Brien wrist score was 93 (80-100) including 25 excellent (93%) and two good (7%) results. Conclusions The technique of antegrade ESIN is effective and minimal invasive for irreducible distal radius fractures in children. The criterion of proximal radius approach to implant ESIN should be studied further in minimal invasive therapy of fractures.

scholarly journals Poor prognostic factors of femoral shaft fractures in children treated by elastic intramedullary nailing

SICOT-J ◽  
2020 ◽  
Vol 6 ◽  
pp. 34
Author(s):  
Alexandru Ulici ◽  
Elena Odagiu ◽  
Oana Haram ◽  
Adelina Ionescu ◽  
Gabriel Alin Sterian ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Intramedullary Nailing ◽  
Femoral Shaft ◽  
Delayed Union ◽  
Elastic Stable Intramedullary Nailing ◽  
Mechanism Of Injury ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures ◽  
Fractures In Children ◽  
Elastic Intramedullary Nailing

Introduction: Femoral shaft fractures in pediatric patients are treated by elastic intramedullary nailing using titanium or stainless-steel nails. The elastic stable intramedullary nailing behaves as an internal splint, promoting early mobilization. This type of treatment involves a minimally invasive approach, no damage to the growth plates, and no impairment of femoral head blood supply. Purpose: The aim of our study was to identify the negative predicting factors that might lead to an increased complication rate after elastic stable intramedullary nailing of femoral shaft fractures in children. Methods: We conducted a retrospective study on 137 patients with femoral shaft fractures treated by elastic stable intramedullary nailing. Patients’ age ranged between 4 and 17 years. We used data from the medical records of the patients to evaluate postoperative complications. Plain radiographs were analyzed to determine the fracture type, fracture location, and postoperative complications such as delayed union, angular deformities, and limb length discrepancies. Multivariate analysis was conducted to identify predictors for poor outcomes. Results: Complications occurred in 29 patients (21%) and consisted of delayed union, axial deformities, or lower limb length discrepancies. In the group of patients that suffered from complications, mechanism of injury, age, and weight were significant. They were older by an average of 5 years; half of them weighed more than 50 kg and over a half were involved in a road traffic accident. Conclusions: Elastic nailing is a successful tool to treat femoral shaft fractures. Three factors were demonstrated to influence the outcome. The mechanism of injury, age > 11 years, and weight > 50 kg are the most important and are predictors for development of complications such as delayed union or deformity.

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>

ATTRITIONAL RUPTURE OF EXTENSOR POLLICIS LONGUS: A RARE COMPLICATION FOLLOWING ELASTIC STABLE INTRAMEDULLARY NAILING OF A PAEDIATRIC RADIAL FRACTURE

Hand Surgery ◽  
2011 ◽  
Vol 16 (01) ◽  
pp. 69-72 ◽  
Author(s):  
James A. Sproule ◽  
Simon J. Roche ◽  
Eswara G. Murthy
Keyword(s):  
Intramedullary Nailing ◽  
Rare Complication ◽  
Paediatric Population ◽  
Elastic Stable Intramedullary Nailing ◽  
Extensor Pollicis Longus ◽  
Elastic Stable Intramedullary Nail ◽  
Acceptable Method ◽  
Forearm Bones ◽  
Diaphyseal Fractures ◽  
Sharp Edges

Elastic stable intramedullary nail fixation has become established as an acceptable method of treatment for diaphyseal fractures of both forearm bones in the paediatric population. It is considered safe, minimally invasive and does not compromise physeal growth. We report a case of delayed rupture of extensor pollicis longus due to attrition over the sharp edges of a protruding nail end after elastic stable intramedullary nailing of a paediatric radial diaphyseal fracture.

scholarly journals Ipsilateral Supracondylar Fracture and Forearm Bone Injury in Children: A Retrospective Review of Thirty one Cases

2012 ◽  
Vol 9 (2) ◽  
pp. 11-16 ◽  
Author(s):  
D Dhoju ◽  
D Shrestha ◽  
N Parajuli ◽  
G Dhakal ◽  
R Shrestha
Keyword(s):  
Bone Fracture ◽  
Closed Reduction ◽  
Supracondylar Fracture ◽  
Radius Fracture ◽  
Type I ◽  
Type Iii ◽  
Bone Injury ◽  
Wire Fixation ◽  
Forearm Bone ◽  
Floating Elbow

Background Supracondylar fracture and forearm bone fracture in isolation is common musculoskeletal injury in pediatric age group But combined supracondylar fracture with ipsilateral forearm bone fracture, also known as floating elbow is not common injury. The incidence of this association varies between 3% and 13%. Since the injury is rare and only limited literatures are available, choosing best management options for floating elbow is challenging. Method In retrospective review of 759 consecutive supracondylar fracture managed in between July 2005 to June 2011, children with combined supracondylar fracture with forearm bone injuries were identified and their demographic profiles, mode of injury, fracture types, treatment procedures, outcome and complications were analyzed. Result Thirty one patients (mean age 8.91 yrs, range 2-14 yrs; male 26; left side 18) had combined supracondylar fracture and ipsilateral forearm bone injury including four open fractures. There were 20 (64.51%) Gartland type III (13 type IIIA and 7 type III B), seven (22.58 %) type II, three (9.67 %) type I and one (3.22 %) flexion type supracondylar fracture. Nine patients had distal radius fracture, six had distal third both bone fracture, three had distal ulna fracture, two had mid shaft both bone injury and one with segmental ulna with distal radius fracture. There were Monteggia fracture dislocation, proximal ulna fracture, olecranon process fracture, undisplaced radial head fracture of one each and two undisplaced coronoid process fracture. Type I supracondylar fracture with undisplaced forearm were treated with closed reduction and long arm back slab or long arm cast. Displaced forearm fracture required closed reduction and fixation with Kirschner wires or intramedullary nailing. Nineteen patients with Gartland type III fracture underwent operative intervention. Among them nine had closed reduction and K wire fixation for both supracondylar fracture and forearm bone injury. One patient with closed reduction and long arm cast application for both type III supracondylar fracture and distal third radius fracture developed impending compartment syndrome and required splitting of cast, remanipulation and Kirschner wire fixation. There were three radial nerve, one ulnar nerve and one median nerve injury and two postoperative ulnar nerve palsy. Three patients had pin tract related complications. Among type III, 16 (80%) patients had good to excellent, two had fair and one gad poor result in terms of Flynn’s criteria in three months follow up ConclusionDisplaced supracondylar fracture with ipsilateral displaced forearm bone injuries need early operative management in the form of closed reduction and percutaneous pinning which provides not only stable fixation but also allows close observation for early sign and symptom of development of any compartment syndrome.DOI: http://dx.doi.org/10.3126/kumj.v9i2.6280 Kathmandu Univ Med J 2011;9(2):11-16 

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 Repair of an open forearm fracture and extensive bony loss (case report)

2021 ◽  
Vol 27 (1) ◽  
pp. 87-91
Author(s):  
Sh.M. Davirov ◽  
◽  
P.U. Urinboev ◽  
Keyword(s):  
High Risk ◽  
Intramedullary Nailing ◽  
Forearm Fracture ◽  
Complete Recovery ◽  
Bony Defect ◽  
Fibular Graft ◽  
Comminuted Fracture ◽  
Soft Tissue Necrosis ◽  
Ilizarov Frame ◽  
Forearm Bones

Introduction Repair of a double open comminuted fracture of forearm bones with extensive bony loss is challenging due to a high risk of infection and the need to address a significant bony defect. Neither internal fixation nor open reduction could be considered due to substantial bone loss and severely impaired circulation with a high risk of soft tissue necrosis and infection. We report staged management of forearm fracture using avascular autologous graft to repair the defect and maintain the forearm length. Objective Demonstrate the successful management of the double open comminuted fracture of forearm bones with extensive bony loss using Ilizarov external fixation, classical autologous grafting harvested from fibula and intramedullary (IM) nailing. Results and discussion The limb was temporarily fixed with Ilizarov frame in an extra-focal manner. An autogenous fibular graft of 11 cm was used to fill in the gap. Intramedullary nailing of the radius and ulna was produced and ulnar defect was repaired with autogenous fibular graft. IM nails were removed once the bones consolidated. The limb function was completely regained, anatomical length of the segment maintained and metal constructs removed. Conclusion Combination of different bone fixation modalities, classical autografting technique and intramedullary nailing provided complete recovery of the broken limb maintaining the function and bringing down the risk of complications to ensure a good clinical result.

scholarly journals Outcome of Intramedullary Stainless steel Rush pins for the treatment of Pediatric diaphyseal forearm bone fracture

2016 ◽  
Vol 12 (2) ◽  
pp. 50-54
Author(s):  
Poojan Kumar Rokaya ◽  
Mangal Rawa ◽  
Javed Ahmad Khan
Keyword(s):  
Stainless Steel ◽  
Bone Fracture ◽  
Open Reduction ◽  
Bone Fractures ◽  
Plate Fixation ◽  
Excellent Result ◽  
Forearm Fracture ◽  
Intramedullary Fixation ◽  
Fractures In Children ◽  
Forearm Bone

Background & Objectives: Pediatric forearm bone fractures are common orthopedic injuries. Generally, these fractures can be successfully managed with closed reduction and casting however operative fixation may be required. Currently, the most common operative interventions are open reduction with plate fixation versus closed or open reduction with intramedullary fixation. Intramedullary fixation materials include Steinmann pins, Kirschner-wires, Rush pins, and elastic titanium nails. To demonstrate the outcome of Intramedullary Stainless steel Rush pins for the treatment of Pediatric diaphyseal forearm bone fracture.Materials & Methods: This study included thirty children with diaphyseal forearm bone fracture treated with intramedullary stainless steel rush pin. Patient’s age, sex, side, mode of injury, fracture type, fixation indication and method, time of clinical and radiological union, complication rate and final range of motion were evaluated at subsequent follow up­. Clinical evaluation was done as per Price’s criteria. Results: Among 30 patients there were 22 boys (73.3%) and 8 girls (26.6%) with a mean age of 11.8 years (Range, 5 to14 years). Twenty (66.6%) patients had right forearm fracture, 10 (33.3%) patients had left forearm fracture. Union was obtained in a mean of 6.5±1.0 weeks (range 6 to 9 weeks). According to the criteria of Price et al. an excellent result was achieved in 25 patients (83.3%) and a good result in five patients (16.6%). Out of total 30 patients six (20%) had minor complications. Conclusion: Fixation with intramedullary stainless steel rush pin produces good to excellent results in diaphyseal forearm bone fractures in children. Based on our experience, rush pins are simple, safe, easily available and affordable to most of the patients in developing countries.JCMS Nepal. 2016;12(2):50-4

Sign in / Sign up

Export Citation Format

Share Document