Comparative study of functional outcome of primary closed intramedullary nailing in compound vs closed tibial diaphyseal fractures

Background: 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.Methods: 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 >19 years; pathological fractures.Results: 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).Conclusions: Fixation with intramedullary TENS nailing is an effective and affordable way of treating patients in paediatric age group.

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Closed intramedullary nailing of diaphyseal fractures

Journal of Trauma and Acute Care Surgery ◽

10.1097/00005373-197701000-00032 ◽

1977 ◽

Vol 17 (1) ◽

pp. 85

Author(s):

V. P Ohotsky

Keyword(s):

Intramedullary Nailing ◽

Diaphyseal Fractures ◽

Closed Intramedullary Nailing

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Functional outcome of elastic stable intramedullary nailing of diaphyseal fractures of paediatric long bones

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20164169 ◽

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

Background: 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.Methods: 44 patients aged 5-15 years suffering from diaphyseal fractures of femur, tibia, humerus, and forearm bones were treated by ESIN with TENs.Results: 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 2nd/3rd day attaining full weight bearing (FWB) in 6-10 weeks. Conclusions: 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.

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Study on Functional Outcome of Elastic Stable Intramedullary Nailing (ESIN) of Diaphyseal Fractures of Paediatric Long Bones

10.9734/bpi/nfmmr/v11/3368f ◽

2021 ◽

pp. 1-9

Author(s):

Arun Vashisht ◽

Gaurav Dev Sharma

Keyword(s):

Functional Outcome ◽

Intramedullary Nailing ◽

Elastic Stable Intramedullary Nailing ◽

Long Bones ◽

Diaphyseal Fractures

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Prospective comparative study of functional outcome of treatment of tibial shaft fracture in adult by cast versus intramedullary nailing

Journal of Clinical Orthopaedics and Trauma ◽

10.1016/s0976-5662(11)60052-0 ◽

2011 ◽

Vol 2 (2) ◽

pp. 99-103 ◽

Cited By ~ 2

Author(s):

Abhijan Maity ◽

Abhigyan Mondal ◽

Bikash Chandra Mondal ◽

Debasish Sinha Roy

Keyword(s):

Comparative Study ◽

Functional Outcome ◽

Intramedullary Nailing ◽

Shaft Fracture ◽

Tibial Shaft Fracture ◽

Tibial Shaft ◽

Prospective Comparative Study

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A prospective comparative study between interlocking nail and locking compression plate for management of diaphyseal fractures of the humerus

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20203055 ◽

2020 ◽

Vol 6 (5) ◽

pp. 926

Author(s):

Mallesh Rathod ◽

Sandeep Kumar Kanugula ◽

Pannuri Raja

Keyword(s):

Comparative Study ◽

Internal Fixation ◽

Functional Outcome ◽

Reoperation Rate ◽

Locking Compression Plate ◽

Interlocking Nail ◽

Operation Rate ◽

Compression Plate ◽

Prospective Comparative Study ◽

Diaphyseal Fractures

Background: The aim of this study was to compare the outcomes between open reduction and internal fixation by locking compression plate (LCP) and closed reduction and internal fixation with anterograde interlocking nail (ILN) for the treatment of diaphyseal fractures of the humerus.Methods: This is a prospective comparative study, with diaphyseal fractures of the humerus treated by LCP in 30 patients and with ILN in 30 patients. Patients were followed up to 18 months. The clinical and radiographic outcomes were assessed in terms of union, complications, reoperation rate and functional outcome using the American shoulder and elbow surgeons’ score (ASES) and Stewart and Hundley’s criteria.Results: Union was achieved in 93.3% of patients in LCP group and 90% in ILN group. The mean blood loss in LCP group was 280±22.10 ml (160-400 ml) and in ILN group was 110±17.62 ml (70-150 ml) (p=0.001). The ASES score was 42.47±5.532 in LCP group and 40.93±6.330 in nailing group (p=0.320; p>0.05). Stewart Hundley criteria showed excellent and good results in 26/30 and 17/30 patients in LCP group and ILN group respectively (p=0.070; p>0.05). Complications and re-operation rate were higher in ILN group.Conclusions: Our study concludes that LCP can be considered a better surgical option for the management of diaphyseal fractures of the humerus as it had lower incidence of complications, less re-operation rate and better union rate. However, there is no difference between the two groups in terms of union time and functional outcome.

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