Surgical Management of Fracture Both Bone Forearm in Pediatric Using Elastic Stable Intramedullary Nail

Abstract IntroductionExternal fixator (EF) is a preferred choice for open tibial fractures, but pin tract infection (PTI) and refracture are common complications. Elastic stable intramedullary nail (ESIN) has been reported in the treatment for open tibial fractures. This study aims to compare the clinical outcomes of EF vs. ESIN in the treatment for open tibial shaft fracture in children retrospectively.Material and methodsPatients aged 5-11 years old with Gustilo-Anderson II and IIIA tibial shaft fracture treated at our institute from January 2008 to January 2018 were reviewed retrospectively and categorized into EF (n = 55) and ESIN (n = 37) group. Patients with pathological fracture, neuromuscular disorder, metabolic disease, previous tibial fracture or instrumentation, and polytrauma were excluded. Patients with follow up less than 24 months or incomplete medical records were also excluded. ResultsIn all, fifty-five patients (33 males, 22 females) were included in the EF group, whereas 37 patients (21 males, 16 females) were included in the ESIN group. There was no significant difference between the two groups concerning sex, age, body weight, duration from injury to surgery, Gustilo-Anderson (GA) classification, and concomitant injuries. There was no patient of nonunion and malunion in either group. The incidence of implant prominence was higher in the ESIN group (16%) than those in the EF group (0), P < 0.001. The angulation was higher in the EF group than ESIN group in coronal and sagittal plane, P < 0.001. The radiological union was faster in the ESIN group (7.0 ± 0.9, weeks) than those in the EF group (9.0 ± 2.2), P < 0.001. Limb length discrepancy (LLD) was significantly longer in the EF group (12.1 ± 4.4, mm) than those in the ESIN group (7.3 ± 4.3, mm), P < 0.001. ConclusionESIN is a viable option in selected patients of GA grade II and IIIA open tibial fractures with comparable clinical outcomes as external fixator, but with less complications including superficial infection, residual angulation and refracture after hardware removal.

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Cortical erosion after elastic stable intramedullary nail fixation for pediatric long bone fractures: Case series according to the site

International Journal of Surgery ◽

10.1016/j.ijsu.2018.05.020 ◽

2018 ◽

Vol 55 ◽

pp. 60-65 ◽

Cited By ~ 1

Author(s):

Kun-Bo Park ◽

Je-Hyun Yoo ◽

Seok Woo Kim ◽

Yoon Hae Kwak

Keyword(s):

Intramedullary Nail ◽

Bone Fractures ◽

Case Series ◽

Long Bone ◽

Elastic Stable Intramedullary Nail ◽

Long Bone Fractures ◽

Cortical Erosion

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Elastic stable intramedullary nail fixation for severely displaced fractures of the neck of the radius in children

Journal of Bone and Joint Surgery - British Volume ◽

10.1302/0301-620x.88b3.17099 ◽

2006 ◽

Vol 88-B (3) ◽

pp. 358-361 ◽

Cited By ~ 22

Author(s):

K. R. Prathapkumar ◽

N. K. Garg ◽

C. E. Bruce

Keyword(s):

Intramedullary Nail ◽

Elastic Stable Intramedullary Nail

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Surgical stabilization for open tibial fractures in children: External fixation or elastic stable intramedullary nail - which method is optimal?

Indian Journal of Orthopaedics ◽

10.4103/0019-5413.189613 ◽

2016 ◽

Vol 50 (5) ◽

pp. 455 ◽

Cited By ~ 1

Author(s):

RohanA Ramasubbu ◽

BenjaminM Ramasubbu

Keyword(s):

External Fixation ◽

Intramedullary Nail ◽

Tibial Fractures ◽

Elastic Stable Intramedullary Nail ◽

Open Tibial Fractures ◽

Fractures In Children

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Comparison of efficacy between internal fixation of minimally invasive elastic stable intramedullary nail and plate in the treatment of pediatric femoral shaft fracture

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.5.513 ◽

2019 ◽

Vol 35 (5) ◽

Cited By ~ 2

Author(s):

Wenxia Wang ◽

Xiaoyong Zheng ◽

Zuoyong Sun

Keyword(s):

Minimally Invasive ◽

Internal Fixation ◽

Fracture Healing ◽

Intramedullary Nail ◽

Femoral Shaft Fracture ◽

Femoral Shaft ◽

Shaft Fracture ◽

Control Group ◽

Observation Group ◽

Elastic Stable Intramedullary Nail

Objective: To compare and analyze the clinical effects of internal fixation of minimally invasive elastic stable intramedullary nail and plate in the treatment of pediatric femoral shaft fracture. Methods: A total of 120 children with femoral shaft fractures who were admitted to our hospital from December 2016 to April 2018 were enrolled. The children were divided into an observation group and a control group by random number table, with 60 children in each group. The children in the observation group underwent internal fixation of minimally invasive elastic stable intramedullary nail, while those in the control group underwent open reduction based on internal fixation of plate. The surgical status and postoperative complications of the two groups were observed and compared, and Kolmert knee function scoring criteria were used for assessing the surgical effects of children. Results: The operation duration, intraoperative blood loss, hospitalization duration, fracture healing time and time of off-bed loaded activity of the observation group were significantly shorter than those of the control group, and the differences were statistically significant (P<0.05). The excellent and good rate of fracture healing in the observation group was 100%, which was higher than that of the control group, 83.33%, and the difference was statistically significant (P<0.05). The total incidence rate of complications in the observation group was 8.33%, which was lower than that of the control group, 10.00%, but the difference was not statistically significant (P>0.05). Conclusion: Pediatric femoral shaft fractures can be treated with internal fixation of minimally invasive elastic intramedullary nail, and it has advantages of significant curative effect, small trauma and fast postoperative recovery, which is conducive to fracture healing and worth promoting. doi: https://doi.org/10.12669/pjms.35.5.513 How to cite this:Wang W, Zheng X, Sun Z. Comparison of efficacy between internal fixation of minimally invasive elastic stable intramedullary nail and plate in the treatment of pediatric femoral shaft fracture. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.513 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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