scholarly journals TITANIUM ELASTIC NAIL - COMPLICATIONS IN THE TREATMENT OF PAEDIATRIC DIAPHYSEAL FRACTURE OF FEMUR§

2013 ◽  
Vol 7 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Saikat Sarkar ◽  
Ranadeb Bandyopadhyay ◽  
Arindam Mukherjee
Keyword(s):  
Femoral Shaft ◽  
Shaft Fracture ◽  
Fracture Site ◽  
Diaphyseal Fracture ◽  
Entry Site ◽  
Superficial Infection ◽  
Femur Fractures ◽  
Titanium Elastic Nailing ◽  
Fractures In Children ◽  
Proximal Migration

Background: Femoral shaft fracture is the most common major paediatric orthopaedic. For generations traction and casting was the standard treatment for all femoral shaft fractures in children. Over the past two decades the advantages of fixation and rapid mobilisation have been increasingly recognised. Methods: A prospective study was conducted in five private hospitals in the district of Bankura, West Bengal over a period of two years (April 2010 to March 2012) on 70 patients with closed shaft femur fractures between 6- 14 years age of either sex. The aim was to find out the short term complications of titanium elastic nailing in diaphyseal fracture of femur in children and compare the findings of this study with pre- existing studies in this field. Results: In our study the most common complication was pain at nail entry site (60%). 5.71% had local inflammatory reaction due to nails. Superficial infection occurred in 2.85%. At the end of 1 year, 2.85% had limb length discripancies. Proximal migration occurred in 2.85%. 2.85% encountered acute reactive synovitis, 5.71% developed angulation of fracture site and 2.85% developed per operative breakage of nail. Conclusion: The treatment of paediatric shaft femur fracture has been drastically changed over the last two decades to internal fixation by elastically stable intra- medullary nail (ESIN). In our study, we encountered only a few complications most of them being minor. Most of the complications were surgical technique related and were seen at the initial phase of the learning curve.

scholarly journals Observational study on titanium elastic nailing in femoral shaft fractures in children

2018 ◽  
Vol 5 (1) ◽  
pp. 32
Author(s):  
Jyotirtmayee Bahinipati ◽  
R. G. Asutosh Mohapatra
Keyword(s):  
Femoral Shaft Fracture ◽  
Femoral Fractures ◽  
Femoral Shaft ◽  
Limb Length Discrepancy ◽  
Shaft Fracture ◽  
Titanium Elastic Nailing ◽  
Fractures In Children ◽  
Group 5 ◽  
One Year ◽  
Prolonged Immobilization

<p class="abstract"><strong>Background:</strong> Nowadays femoral fractures in children are more commonly managed with operative fixation rather than conservative treatment because of more rapid recovery and avoidance of prolonged immobilization. Our aim of study was to assess the outcome of titanium elastic nailing in femoral shaft fracture in children.</p><p class="abstract"><strong>Methods:</strong> Twenty five children in age group 5-15 years with femoral shaft fracture were stabilized with two titanium nails. Children were followed up for one year. The operative outcome was evaluated using criteria of Flynn. Complications associated with procedure were recorded and analyzed.<strong></strong></p><p class="abstract"><strong>Results:</strong> The final outcome was excellent in 67% (19 of 25) of patients, satisfactory in 16% (4 of 25) of patients and poor in 8% (2 of 25) of patients. Poor outcome was due to limb length discrepancy, pain in the knee and angular misalignment.</p><p class="abstract"><strong>Conclusions:</strong> We concluded that titanium elastic nailing is an ideal method of femoral shaft fixation in children.</p>

Outcome of Titanium Elastic Nailing in the Surgical Management of Femoral-Shaft Fracture in Children

2020 ◽  
Vol 2 (2) ◽  
pp. 61-66
Author(s):  
Rajram Maharjan ◽  
Rishi Bisht ◽  
Dipesh Pariyar
Keyword(s):  
Femoral Shaft Fracture ◽  
Insertion Site ◽  
Operating Time ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
Age Group ◽  
Femoral Shaft Fractures ◽  
Titanium Elastic Nailing ◽  
Shaft Fractures ◽  
Fractures In Children

Introduction: Femoral shaft fracture is one of the most common orthopedic injuries of the children. These fractures treated non-operatively by traction followed by hip spica require prolonged hospitalization causing undue physical and psychological stress for patient and patient family. Loss of reduction is also commonly seen with hip spica that leads to unacceptable complications like angular deformities and limb length discrepancies. Titanium Elastic Nailing (TEN) is becoming widely accepted treatment for femoral shaft fractures in children due to its simplicity and physeal protective stable load sharing construct that allows early mobilization. The purpose of this study was to see the outcome of operative treatment of femoral shaft fracture in children by TEN. Methods: A retrospective observational study was carried out in the Department of Orthopedics in National Academy of Medical Sciences, National Trauma Center from February 2017 to January 2019. Study was undertaken in 22 children between the age group of 5-14 years with femoral shaft fractures. Fixation with TEN was done for all fractures within nine days of injury. Patients were assessed radiologically as well as clinically until fractures healed. The results were evaluated using Flynn scoring criteria. Results: Radiological union was seen in all cases between 6–12 weeks after surgery. The mean operating time was 58 (48-115) minute and mean hospital stay after surgery was 9 (6-15) days. Results were excellent in 14 patients (63.63%), satisfactory in 6 patients (27.37%) & poor in 2 patients (9%). Six patients had skin irritation at nail insertion site which resolved after removal of nails. Functional range of motion in both hip and knee joints of affected limb was preserved in all cases after the removal of nails. Conclusion: TEN is an effective and safe treatment of femoral shaft fractures in children of 5-14 years of age group.  

Management of complex femur fractures in children: A report of Three Cases

2021 ◽  
Vol 11 (10) ◽  
Author(s):  
Shrihari L Kulkarni ◽  
Sunil Mannual ◽  
Manjunath Daragad ◽  
Naveenkumar Patil ◽  
Daniel Ernest
Keyword(s):  
Intertrochanteric Fracture ◽  
Dynamic Compression ◽  
Shaft Fracture ◽  
Femur Fractures ◽  
Titanium Elastic Nailing ◽  
Shaft Fractures ◽  
Fractures In Children ◽  
Operative Planning ◽  
Femur Shaft ◽  
Femur Shaft Fractures

Introduction:Complex femur fractures are defined as combined fractures of shaft and proximal of or the distal femur. Restoration of anatomical alignment is the primary goal of the management of these fractures. In this report, we describe the management of complex femur shaft fractures in three pediatric patients. Case Report: This report includes three patients. The first patient was a 10-year-boy with comminuted proximal femur shaft fracture extending into the subtrochanteric area, managed with minimally invasive sub-muscular plating. The second patient was a 12-year-boy with comminuted femur shaft extending into subtrochanteric area, treated with combined retrograde and anterograde Titanium Elastic Nail System. A 12-year-old boy with femur shaft with intertrochanteric fracture managed with K-wire fixation for intertrochanteric fracture and plating with dynamic compression plate for femur shaft was our third patient. All patients had excellent radiological and functional outcome. Conclusion: Complex femur shaft fractures in children are very rare and challenging injuries. With proper pre-operative planning and use of appropriate implants excellent outcomes can be obtained. Keywords:Complex femur fractures, pediatric orthopedics, sub-muscular plating, titanium elastic nailing.

scholarly journals Titanium Elastic Nailing System (TENS) for Tibia Fractures in Children: Functional Outcomes and Complications

2016 ◽  
Vol 55 (204) ◽  
pp. 55-60 ◽  
Author(s):  
Kapil Mani KC ◽  
Parimal Acharya ◽  
Arun Sigdel
Keyword(s):  
Functional Outcomes ◽  
Skin Irritation ◽  
Limb Lengthening ◽  
Delayed Union ◽  
Tibial Fractures ◽  
Entry Site ◽  
Superficial Infection ◽  
Non Union ◽  
Fractures In Children ◽  
Tibia Fractures

Introduction: Closed reduction and cast application is still regarded as first line treatment for pediatric tibial fractures. Over the past few decades, management of pediatric tibial fractures has shifted more towards operative intervention because of quicker recovery, shorter rehabilitation period, less immobilization, lack of stiffness of adjoining joints, and less psychological impact to the children. Flexible intramedullary nails not only fulfill the above advantage but also maintain alignment and rotation.Methods: This was a retrospective study of pediatric tibial fractures fixed with two titanium elastic nails through proximal ends of bones. Alignment of fracture, any infection, delayed union, non union, limb length discrepancy, motion of knee joint, and fracture union time were measured during follow-up examination.Results: Forty-five patients were enrolled into the study out of which 28 (62.2%) were male and 17 (37.8%) were female. Average age of patient was 9.48±2.17 years and average time taken to heal the fractures (both clinical and radiological) was 11.17±2.81 weeks. There were 2 (4.4%) of malunion, 4 (8.8%) of delayed union, 3 (6.6%) of limb shortening, 2 (4.4%) of limb lengthening, 6 (13.6%) of nail prominence and skin irritation, 2 (4.4%) of superficial infection at nail entry site and one case of re-fracture.Conclusions: Titanium elastic nail fixation is a simple, easy, rapid, reliable and effective method for management of pediatric tibial fractures in patients with operative indications. There may be the chances of complication following the TENS in tibia but these are avoidable as well as manageable with careful precautions. Keywords: complications; functional outcomes; tibia fractures. | PubMed

scholarly journals The Cortical Step Sign Fails to Prevent Malrotation of a Nailed Femoral Shaft Fracture: A Case Report

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Taranjit Tung ◽  
Ted Tufescu
Keyword(s):  
Case Report ◽  
Intramedullary Nailing ◽  
Femoral Shaft Fracture ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
Rotational Deformity ◽  
Femoral Nailing ◽  
Femur Fractures ◽  
Clinically Significant

Intramedullary nailing has become the treatment of choice for diaphyseal femur fractures. Malrotation is a well-recognized complication of femoral nailing. Various techniques including the cortical step sign (CSS) have been described to minimize iatrogenic rotational deformity during femoral nailing. We present a case in which the use of the CSS resulted in a clinically significant malrotation requiring revision.

Titanium Elastic Nailing has Superior Value to Plate Fixation of Midshaft Femur Fractures in Children 5 to 11 Years

2018 ◽  
Vol 38 (3) ◽  
pp. e111-e117 ◽  
Author(s):  
Jerad D. Allen ◽  
Kevin Murr ◽  
Ferras Albitar ◽  
Cale Jacobs ◽  
Eric S. Moghadamian ◽  
...  
Keyword(s):  
Plate Fixation ◽  
Femur Fractures ◽  
Titanium Elastic Nailing ◽  
Fractures In Children

Determine the Mean Duration of Union in Femoral Shaft Fracture in Children Treated with Elastic Intra-Medullary Nailing

2021 ◽  
Vol 15 (5) ◽  
pp. 1338-1340
Author(s):  
M. S. Zardad ◽  
M. Younas ◽  
S. A. Shah ◽  
I. Muhammad ◽  
M. Ullah ◽  
...  
Keyword(s):  
Intramedullary Nailing ◽  
Functional Outcomes ◽  
Femoral Shaft Fracture ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
Femoral Shaft Fractures ◽  
Non Union ◽  
Shaft Fractures ◽  
Fractures In Children ◽  
Medullary Nailing

Objective: The aim of this study is to determine the functional outcomes and mean duration of union in femoral shaft fracture in children treated with elastic intra-medullary nailing. Study Design:Retrospective Place and Duration: Conducted at Orthopaedic Unit Ayub Medical Teaching Institute Abbottabad and District Headquarter Teaching Hospital Gomal Medical College Dera Ismail Khan for duration from May 2020 to January 2021 (09 months). Methods: Total sixty eight patients with age ranges between 5-12 years were presented in this study. Patients detailed demographics age, sex and BMI were calculated after taking informed written consent. Complete patients were treated with elastic intramedullary nailing. Radiological assessment was done. Mean union time and complications associated to procedure were examined. Functional outcomes were analyzed according to the Flyn’s criteria. Follow-up was taken at 8 months postoperatively. Complete data was analyzed by SPSS 22.0 version. Results: Out of 68 patients, there were 48 (68.6%) males and 20 (31.4%) females. Most of the patients 41 (60.35) were aged between 8-12 years and the rest 27 (39.65%) were between 5-8 years.34 (50%) fractures were caused because of road accidents, falling from height were 20 (29.41%), due to sports were 10 (14.70%) and 4 (5.9%) were due to simple fall. 32 (47.06%) patients had left side fracture and 36 (52.94%) had right side fracture. Mean union time among patients was 4.14±2.72 months and there was no any case of non union. According to Flyn’s criteria, 50 (73.53%) cases had excellent results, 14 (20.6%) patients had good and fair results were among 4 (5.9%) cases. Complications were observed bone stiffness, delayed union and varus deformity among all cases. Conclusion: We concluded in this study thatElastic intramedullary nailing for femoral shaft fractures in children is safe and effective treatment modality. Union of bone achieved all the patients and majority of patients had excellent functional outcomes. Keywords: Femoral shaft fractures, Children, Elastic intra-medullary nail

scholarly journals FUNCTIONAL OUTCOME OF FRACTURE SHAFT OF FEMUR IN PEDIATRIC AGE GROUP TREATED WITH TITANIUM ELASTIC NAILING SYSTEM

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Vishal Kumar Mishra ◽  
Arvind Kumar ◽  
Gutha Sethu Kumar ◽  
Siddhartha Sarang
Keyword(s):  
Functional Outcome ◽  
Femoral Shaft ◽  
Early Mobilization ◽  
Age Group ◽  
Pediatric Age ◽  
Diaphyseal Fracture ◽  
Femoral Shaft Fractures ◽  
Pediatric Age Group ◽  
Titanium Elastic Nailing ◽  
Diaphyseal Fractures

Femoral shaft fractures are common fractures in paediatric age group. In children, fractures of the femoral shaft have been traditionally treated mostly by conservatively immobilization in a Spica cast, either immediately or after a period of traction. But this safe form of treatment has major drawbacks. The management of paediatric femoral shaft fractures gradually has evolved towards a more operative approach in the past decade. Elastic stable intramedullary nailing (ESIN) or Titanium elastic nailing system (TENS) is a recent technique which allows stable reduction, maintenance of reduction and early mobilization. . Aim of study is to assess the functional outcome of fracture shaft of femur in pediatric age group treated with titanium elastic nailing system. It is a prospective study which was conducted in the all children between 5-14 years of age with diaphyseal fractures of femur. Outcome of  fracture  shaft  of  femur  in  pediatric  age  group  treated  with titanium elastic nailing system was studied studied by observing following, Type of reduction among children with diaphyseal fractures of femur, .Duration for union after surgery , Range of motion after surger, weeks of  Weight Bearing started , Limb length discrepancy, Malalignment . From present study we conclude that femur diaphyseal fracture in children between 5-14 years of age can be effectively managed with titanium elastic nails. TENS offers a biological, minimally invasive method of treatment for fracture shaft of femur in children with advantages of sufficient axial stability, early mobilization and more rapid return to function. this technique yields higher rate of excellent functional outcome. Keywords: Femur, Diaphyseal Fracture,  Children, TENS

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