scholarly journals Clinical and radiological evaluation of minimally invasive intramedullary fixation by titanium elastic nails in paediatric long bone fractures of lower limb: a prospective study

2019 ◽  
Vol 5 (5) ◽  
pp. 816
Author(s):  
A. Sandeep ◽  
Jayant Jain
Keyword(s):  
Intramedullary Nailing ◽  
Complication Rate ◽  
Bone Fractures ◽  
Full Range ◽  
Elastic Stable Intramedullary Nailing ◽  
Long Bone ◽  
Ankle Motion ◽  
Soft Tissue Envelope ◽  
Internal Support ◽  
Diaphyseal Fractures

<p class="abstract"><strong>Background:</strong> Elastic stable intramedullary nailing for the treatment of paediatric femur and tibial diaphyseal fractures was introduced by Prevot and colleagues in 1979. It follows three-point fixation principle that provides internal support in presence of cortical contact and an intact soft-tissue envelope. This technique has many advantages, including better reduction, dynamic axial stabilization, shorter hospitalization with early rehabilitation and low complication rate.</p><p class="abstract"><strong>Methods:</strong> This is a prospective observational study done at Kauvery Medical Centre, Trichy between May 2017 to May 2018 consisting of 39 children between age 5 to 16 years with diaphyseal fractures of femur and tibia. The fractures were treated by closed reduction and internal fixation with titanium elastic intramedullary nailing. The patients were evaluated clinically and radiologically and followed for an average of 6 months. Outcome was assessed using transcutaneous electrical nerve stimulation (TENS) scoring system used by Flynn et al.<strong></strong></p><p class="abstract"><strong>Results:</strong> Our series consisted of 39 patients (22 cases with fracture shaft of femur and 17 cases with fracture shaft of tibia), 33 males and only 6 females. Average time for radiological union was 9.89 weeks. All patients had full range of hip and ankle motion and 2 (5.1%) patients had mild restriction in knee flexion at 12 weeks.</p><p class="abstract"><strong>Conclusions:</strong> Elastic stable intramedullary nailing is an ideal method for treatment of paediatric femoral and tibial diaphyseal fractures due to lower complication rate and good functional outcome in comparison to other methods of treatment.</p>

scholarly journals Outcome of shaft fractures among children treated with elastic stable intramedullary nailing

2020 ◽  
Vol 8 (5) ◽  
pp. 1662
Author(s):  
Mahmood Ahmad ◽  
Tahir El Tahir ◽  
Saba Ahmad ◽  
Umair Ahmad
Keyword(s):  
Intramedullary Nailing ◽  
Bone Fractures ◽  
Elastic Stable Intramedullary Nailing ◽  
Postoperative Treatment ◽  
Long Bone ◽  
Bony Union ◽  
Orthopedic Injury ◽  
Long Bone Fractures ◽  
Shaft Fractures ◽  
Fractures In Children

Background: Long bone fractures are frequent occurrence among children and considered a frequent pediatric orthopedic injury requiring hospitalization. Authors aimed to retrospectively analyze the outcome of fixation of long bone fractures with elastic stable intramedullary nailing (ESIN) among children and adolescents.Methods: From 2010 to 2018, ESIN was performed on 128 children aged 2 to 17 years having single shaft fractures of long bones. The data related to associated injuries, postoperative complications, postoperative treatment, till bony union or removal of rods, mal-union, functional deficit, need for secondary surgical intervention and subjective complaints at follow-up originated from postoperative clinical and radiological consultations carried out regularly. The primary end points were time of complete radiological union or removal of rods.Results: The mean age at the time of accident was 9.5 years. There were 37 (28.9%) femoral fractures, 16 (12.5%) of the lower leg, 51 (39.8%) fractures of radius/ulna and 24 (18.8%) of the humerus. In 2 (2.3%) children, reoperation was necessary due to prominent ends of elastic rods and 6 (4.7%) had early removal of rods due to same reasons. End point of the study, removal of rods noted in 126 (82.8%), radiological evidence of union in 7 (5.5%) and 15 (11.7%) cases were lost at follow-up.Conclusions: ESIN fixation of diaphyseal fractures in children and adolescents is safe. ESIN was found to be minimally invasive method, noted to produce excellent functional as well as cosmetic outcomes.

scholarly journals Evaluation of surgical fixation of paediatric diaphyseal long bone fractures in lower limb with elastic stable intramedullary nailing (Esin)

2017 ◽  
Vol 3 (4g) ◽  
pp. 501-504
Author(s):  
Dr. Kamal Kumar Arora ◽  
Dr. Simranjit Singh ◽  
Dr. Priti Chaudhary ◽  
Dr. Rajesh Kapila ◽  
Dr. Rajan Sharma ◽  
...  
Keyword(s):  
Intramedullary Nailing ◽  
Lower Limb ◽  
Bone Fractures ◽  
Elastic Stable Intramedullary Nailing ◽  
Long Bone ◽  
Long Bone Fractures ◽  
Surgical Fixation

scholarly journals The advent of elastic stable intramedullary nailing for the treatment of long bone fractures in skeletally immature patients

2021 ◽  
Vol 27 (4) ◽  
pp. 406-412
Author(s):  
A. Andreacchio ◽  
◽  
F. Alberghina ◽  
F. Canavese ◽  
◽  
...  
Keyword(s):  
Intramedullary Nailing ◽  
Bone Fractures ◽  
Weight Bearing ◽  
Surgical Techniques ◽  
Early Mobilization ◽  
Elastic Stable Intramedullary Nailing ◽  
Long Bone ◽  
Long Bones ◽  
Skeletally Immature ◽  
Fractures In Children

Introduction Management of pediatric long bones fractures is a complex and rapidly evolving field. Traditionally, casting and conservative techniques played a key-role in the management of fractures in skeletally immature patients. However, the surgical approach has evolved steadily over the past four decades or so and increasing evidence has been published supporting the advantages of fixation techniques over conservative methods. The purpose of this narrative review is to outline how innovations in orthopedic surgery have changed the rationale of treating long bones fractures in children and adolescents with focus on surgical techniques, particularly elastic stable intramedullary nailing (ESIN). Material and methods We aimed to describe the main trends in pediatric long bones fractures management and to identify its specificities and difficulties as well as the best standard of care. Results The introduction of ESIN has profoundly influenced the management of pediatric upper and lower extremity fractures. Overall, in comparison to conservative techniques, advantages of ESIN include minimally invasiveness, short hospital stay, primary bone union, early mobilization and progressive weight bearing, and good outcome with low complication rate. Moreover, the flexible nail can be used as a closed reduction tool itself. Conclusions Irrespective of the technique performed, the key-concepts remain 1) the proper understanding of the injury to treat; 2) the identification the main characteristics of the patient; 3) the pros and cons of each technique; and 4) the potential complications.

Elastic Stable Intramedullary Nailing for Pediatric Long Bone Fractures: Experience with 175 Fractures

2011 ◽  
Vol 100 (3) ◽  
pp. 208-215 ◽  
Author(s):  
D. Furlan ◽  
Z. Pogorelić ◽  
M. Biočić ◽  
I. Jurić ◽  
D. Budimir ◽  
...  
Keyword(s):  
Intramedullary Nailing ◽  
Bone Fractures ◽  
Elastic Stable Intramedullary Nailing ◽  
Long Bone ◽  
Long Bone Fractures

scholarly journals Irradiation level related to intraoperative imaging device in paediatric elastic stable intramedullary nailing: preliminary prospective study on 51 patients using PCXMC software

2020 ◽  
Vol 14 (5) ◽  
pp. 451-458
Author(s):  
Marc Prod’homme ◽  
Pierre-Louis Docquier ◽  
Othmane Miri ◽  
Marta Sans-Merce ◽  
Anne Tabard-Fougère ◽  
...  
Keyword(s):  
Intramedullary Nailing ◽  
Bone Fractures ◽  
Irradiation Time ◽  
Intraoperative Imaging ◽  
Elastic Stable Intramedullary Nailing ◽  
Long Bone ◽  
Secondary Outcome ◽  
Level Of Evidence ◽  
Imaging Device ◽  
Risk Of Cancer

Purpose Radiation-induced cancers due to imaging devices concern above all the growing child, however, to date, intraoperative irradiation doses are not well-documented in children. The goal of the study was to evaluate the intraoperative doses received by patients operated with the use of a C-arm in traumatology, as well as the lifetime attributable risk of cancer death (LAR) related to the irradiation of the imaging device. Methods From 1 April 2017 to 31 March 2019, we started a multicentre study and prospectively recruited all consecutive children who needed elastic stable intramedullary nailing (ESIN) for long-bone fracture. We collected demographic and operative data, with dose reports including duration and doses. The main outcome was the effective dose (ED) in millisievert (mSv), calculated with PCXMC software, and the secondary outcome was the LAR expressed as a percentage. Results In all, 51 patients operated on using 2D C-arm imaging were included in this study. The mean ED was 0.085 mSv (sd 0.10; 0.002 to 0.649). Overall LAR was 6.5 x 10−4% (sd 6.7 x 10−4%; 0.1 x 10−4% to 28.3x10−4%). Univariate linear regression showed a significant association between ED and irradiation time (p < 0.001). There was no significant association between ED and other outcomes (p > 0.05). Conclusion Treatment of long-bone fractures by ESIN found a low level of effective doses with utilization of the C-arm device in current practice. Further studies on a larger sample are needed to confirm these results. Level of Evidence II

scholarly journals Complications of Elastic Stable Intramedullary Nailing for treating paediatric long bone fractures

2013 ◽  
Vol 10 (1) ◽  
pp. 17-24 ◽  
Author(s):  
Aamer Nisar ◽  
Abhijit Bhosale ◽  
Sanjeev S. Madan ◽  
Mark J. Flowers ◽  
James A. Fernandes ◽  
...  
Keyword(s):  
Intramedullary Nailing ◽  
Bone Fractures ◽  
Elastic Stable Intramedullary Nailing ◽  
Long Bone ◽  
Long Bone Fractures

Prognostic factors for surgical site infection following intramedullary nailing of diaphyseal fractures of the femur and tibia in adult patients at a tertiary hospital in Lusaka, Zambia

2021 ◽  
pp. 004947552110646
Author(s):  
Webster Musonda ◽  
Derek Freitas ◽  
Kaunda Yamba ◽  
William Jim Harrison ◽  
James Munthali
Keyword(s):  
Prognostic Factors ◽  
Surgical Site Infection ◽  
Intramedullary Nailing ◽  
Tertiary Hospital ◽  
Alternative Methods ◽  
Long Bone ◽  
Site Infection ◽  
Resource Setting ◽  
Early Return ◽  
Diaphyseal Fractures

Our study aimed to identify prognostic factors for surgical site infection following long bone fracture intramedullary nailing at a tertiary hospital in a low-resource setting. This was a longitudinal observational study involving 132 participants enrolled over a one-year period with femoral and tibial diaphyseal fractures scheduled for ORIF. Participant median age was 30 years (range: 26 – 42). The prevalence of surgical site infection was 16%. Male sex (AOR=0.26, 95% CI [0.70–0.98]; p = 0.047) was associated with lower odds of surgical site infection while associated non-musculoskeletal injuries were associated with higher odds of developing surgical site infection. Our study confirms a higher surgical site infection rate than normally accepted. However, intramedullary nailing in our setting is justified as it allows an early return to a pre-injury state. These interventions must be carried out in the best possible circumstances. Future studies could explore alternative methods of fracture fixation.

Sign in / Sign up

Export Citation Format

Share Document