scholarly journals Titanium elastic percutaneous nails for pediatric long bone shaft fractures: current concept

2017 ◽  
Vol 16 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Ramji Lal Sahu ◽  
Nadeem Ahmed
Keyword(s):  
Bone Fractures ◽  
Weight Bearing ◽  
Medical Science ◽  
Early Mobilization ◽  
Lower Limbs ◽  
Long Bone ◽  
Full Weight Bearing ◽  
Entry Site ◽  
Early Weight Bearing ◽  
Mean Time

Introduction: The objective of this study was to determine the effectiveness and the complications associated with elastic stable intramedullary nailing in long bone fractures in children.Methods: This study was conducted in the Department of Orthopaedic surgery in M. M. Medical College from July 2006 to November 2009. Eighty two patients were recruited from Emergency and out patient department having closed fracture of long bones of upper and lower limbs. All patients were operated under general or spinal anaethesia. All patients were followed for twelve months.Results: All children achieved union in a mean time of 10 weeks (range from 6 - 16 weeks) depending on the type of long bone. Full weight bearing was possible in a mean time of 8.8 weeks. Mean duration of hospital stay was 9.8 days. The mean follow-up period was 28 months (17-48 months). Complications were recorded in 5 (6.09%) patients and included: two entry site skin irritations, one protrusion of the wires through the skin and two delayed union. The results were excellent in 97.310% and good in 2.44% patients.Conclusion: We concluded that this technique is advantageous because of early mobilization (early weight bearing), less complication with good results and is economical.Bangladesh Journal of Medical Science Vol.16(1) 2017 p.61-68

scholarly journals A Comparative Study Of Surgical Management Of Subtrochanteric Fractures In Children

2012 ◽  
Vol 11 (3) ◽  
pp. 178-184
Author(s):  
RL Sahu ◽  
P Gupta
Keyword(s):  
Femoral Fracture ◽  
Weight Bearing ◽  
Excellent Result ◽  
Medical Science ◽  
Long Bone ◽  
Full Weight Bearing ◽  
Entry Site ◽  
Early Weight Bearing ◽  
Fractures In Children ◽  
Mean Time

Introduction: Subtrochateric femoral fracture is a major cause of morbidity and mortality in patients with lower extremity injuries. There have been no studies that have specifically looked at the management of subtrochanteric femoral fractures in skeletally immature adolescents. It was the purpose of this study to investigate the treatment of this injury in this unique patient population. Methods: This study was conducted in the Department of Orthopaedic surgery in M. M. Medical College from July 2006 to November 2008. Thirty-four patients were recruited from Emergency and out patient department having closed subtrochanteric femoral fracture. All patients were operated under general or spinal anesthesia. All patients were    followed for twelve months. Results: All children achieved union in a mean time of 10 weeks (range from 6 - 16 weeks) depending on the type of long bone. Full weight bearing was possible in a mean time of 8.8 weeks. Mean duration of hospital stay was 9.8 days. The mean follow-up period was 28 months (17-48 months). Complications were recorded in 4 (11.77%) patients and included: two entry site skin irritations, one protrusion of the wires through the skin and one delayed union. The results were excellent in 97.06% and good in 2.97% patients. Conclusions: We conclude that Rigid and close interlocking nailing between  the age of 9-16 years offered excellent fracture stability allowing early mobilization (early weight bearing) and joint motion in comparisons to the other groups and between the age of 6-8 years titanium elastic nail and bridging plate offered excellent result. DOI: http://dx.doi.org/10.3329/bjms.v11i3.11718 Bangladesh Journal of Medical Science Vol. 11 No. 03 July’12  

scholarly journals A comparative study of surgical management of subtrochanteric fractures in children

2012 ◽  
Vol 11 (2) ◽  
pp. 91-97
Author(s):  
Ramji Lal Sahu ◽  
Pratiksha Gupta
Keyword(s):  
Femoral Fracture ◽  
Weight Bearing ◽  
Medical Science ◽  
Femoral Fractures ◽  
Long Bone ◽  
Full Weight Bearing ◽  
Entry Site ◽  
Early Weight Bearing ◽  
Fractures In Children ◽  
Mean Time

Introduction: Subtrochateric femoral fracture is a major cause of morbidity and mortality in patients with lower extremity injuries. There have been no studies that have specifically looked at the management of subtrochanteric femoral fractures in skeletally immature adolescents. It was the purpose of this study to investigate the treatment of this injury in this unique patient population. Methods: This study was conducted in the Department of Orthopaedic surgery in M. M. Medical College from July 2006 to November 2008. Thirty-four patients were recruited from Emergency and out patient department having closed subtrochanteric femoral fracture. All patients were operated under general or spinal anesthesia. All patients were followed for twelve months. Results: All children achieved union in a mean time of 10 weeks (range from 6 - 16 weeks) depending on the type of long bone. Full weight bearing was possible in a mean time of 8.8 weeks. Mean duration of hospital stay was 9.8 days. The mean follow-up period was 28 months (17-48 months). Complications were recorded in 4 (11.77%) patients and included: two entry site skin irritations, one protrusion of the wires through the skin and one delayed union. The results were excellent in 97.06% and good in 2.97% patients. Conclusions: We conclude that Rigid and close interlocking nailing between the age of 9-16 years offered excellent fracture stability allowing early mobilization (early weight bearing) and joint motion in comparisons to the other groups and between the age of 6-8 years titanium elastic nail and bridging plate offered excellent result.DOI: http://dx.doi.org/10.3329/bjms.v11i2.9664 Bangladesh Journal of Medical Science Vol. 11 No. 02 April 2012: 91-97

Structural Health Monitoring of Long Bone Fractures Using Instrumented Intramedullary Nails

2008 ◽  
Author(s):  
Darren Wilson ◽  
Si Janna
Keyword(s):  
Fracture Healing ◽  
Stance Phase ◽  
Bone Fractures ◽  
Weight Bearing ◽  
Long Bone ◽  
Full Weight Bearing ◽  
Radiographic Evidence ◽  
Linear Load ◽  
Single Sensor ◽  
Primary Bone

Clinical assessment of fracture healing is usually subjective, relying upon the detection of movement (‘feel’) by the surgeon, the patient’s response in terms of pain and confidence, and radiographic evidence of callus and primary bone union. A more quantitative, objective method of measuring the strength of a healing callus would be useful in assessing many aspects, such as the effectiveness of different forms of treatment, the pattern and rate of healing, and the stage at which the patient can return to full weight-bearing activity. The results presented in this paper demonstrate the complexity of monitoring fracture healing in leg stance phase using an instrumented intramedullary (IM) nail equipped with a single sensor. The bone healers exhibited both sigmoidal and linear load responses during fracture healing. Ambulating non-healers demonstrated high nail forces which did not change significantly over time whereas lame non-healers demonstrated a decreasing nail load due to reduced GRF or loosening of fixation.

scholarly journals Update Review and Clinical Presentation in Congenital Insensitivity to Pain and Anhidrosis

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
L. M. Pérez-López ◽  
M. Cabrera-González ◽  
D. Gutiérrez-de la Iglesia ◽  
S. Ricart ◽  
G. Knörr-Giménez
Keyword(s):  
Therapeutic Approach ◽  
Bone Fractures ◽  
Weight Bearing ◽  
Genetic Mutation ◽  
Review Literature ◽  
Long Bone ◽  
Early Weight Bearing ◽  
Congenital Insensitivity ◽  
Congenital Insensitivity To Pain ◽  
Insensitivity To Pain

Introduction. Congenital insensitivity to pain and anhidrosis (CIPA) or hereditary sensory and autonomic neuropathy type IV is an extremely rare syndrome. Three clinical findings define the syndrome: insensitivity to pain, impossibility to sweat, and mental retardation. This pathology is caused by a genetic mutation in the NTRK1 gene, which encodes a tyrosine receptor (TrkA) for nerve growth factor (NGF).Methods. The consultation of a child female in our center with CIPA and a tibia fracture in pseudoarthrosis encouraged us to carefully review literature and examine the therapeutic possibilities. A thorough review of literature published in Pubmed was done about CIPA and other connected medical issues mentioned in the paper.Conclusions. The therapeutic approach of CIPA remains unclear. The preventive approach remains the only possible treatment of CIPA. We propose two new important concepts in the therapeutic approach for these patients: (1) early surgical treatment for long bone fractures to prevent pseudoarthrosis and to allow early weight bearing, decreasing the risk of further osteopenia, and (2) bisphosphonates to avoid the progression of osteopenia and to reduce the number of consecutive fractures.

scholarly journals Radiation-free interlocking intramedullary nailing of three-hundred and seventy long bone fractures in Ogbomoso, Nigeria

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Stephen Adesope Adesina ◽  
Samuel Uwale Eyesan ◽  
Innocent Chiedu Ikem ◽  
Olalekan Akeem Anipole ◽  
Isaac Olusayo Amole ◽  
...  
Keyword(s):  
Developing Countries ◽  
Bone Fractures ◽  
Weight Bearing ◽  
Age Groups ◽  
Previous Treatment ◽  
Long Bone ◽  
Full Weight Bearing ◽  
Post Discharge ◽  
Long Bone Fractures ◽  
Wide Range

AbstractLong bone fracture care in developing countries remains largely different from that of the developed world where closed reduction and internal fixation with locked intramedullary nail is the standard treatment. This study in a developing country presents the pattern and outcome of treatment of 370 long bone fractures using the SIGN nail over a five-year period in order to underline the wide array of patients and fractures treatable with the nail. Using a prospective descriptive approach, all the 342 patients with 370 fractures of the humerus, femur and tibia treated from July 2014 to June 2019 were studied. The fractures were reduced without image intensifier or fracture table and fixed with the SIGN nail. Post-discharge, the patients were followed up at the out-patient clinic. The mean age of the patients was 43.45 years with a range of 10–99 years. Sixty-six percent were males who were mostly injured in motorcycle accidents. Femur, tibia and humerus fractures accounted for 59.7%, 28.4% and 11.9% respectively. Eighty-six percent were diaphyseal fractures, 73% were fresh and the main previous treatment was traditional bone setting. Deep infection occurred in 4.9%, 66.0% achieved knee flexion > 90° by sixth week, the majority achieved full weight bearing and could squat and smile by 12th week. The SIGN nail is versatile, useful for treating a wide range of fractures in most age groups particularly in developing countries where orthopaedic fractures are prevalent but the more sophisticated facilities are lacking or poorly maintained.

scholarly journals Nail or plate in the management of distal extra-articular tibial fracture, what is better? Valutation of outcomes

SICOT-J ◽  
2018 ◽  
Vol 4 ◽  
pp. 2 ◽  
Author(s):  
Michele Bisaccia ◽  
Andrea Cappiello ◽  
Luigi Meccariello ◽  
Giuseppe Rinonapoli ◽  
Gabriele Falzarano ◽  
...  
Keyword(s):  
Bone Fractures ◽  
Weight Bearing ◽  
Excellent Result ◽  
Operation Time ◽  
Tibial Fractures ◽  
Long Bone ◽  
Full Weight Bearing ◽  
Distal Tibial Fractures ◽  
Study Results ◽  
The Mean

Introduction: Distal tibial fractures are the most common long bone fractures. Several studies focusing on the methods of treatment of displaced distal tibial fractures have been published. To date, locked plates, intramedullary nails and external fixation are the three most used techniques. The aim of our study was to compare intramedullary nail (IMN) and locked plate (LP) for treatment of this kind of fracture. Materials and methods: We collected data on 81 patients with distal tibial fractures (distance from the joint between 40 and 100 mm) and we divided into two groups: IMN and LP. We compared in the 2 groups the mean operation time, the mean union time, the infection rate the rate of malunion and nonunion, the full weight bearing time. Results: No patient in the two groups developed a nonunion. None of the patients obtained a fair or poor outcome. Overall 52 patients obtained an excellent result (69.3%) and 23 obtained a good result (30.6%). Discussion: Our study results indicate a superiority of IMN over LP in terms of lower rates of infections and statistically significant shorter time to full weight bearing. Whereas LP appeared to be advantageous over IMN in terms of leading to a better anatomical and fixed reductions of the fracture and a lower rate of union complications. The two treatments achieved comparable results in terms of operation time, hospital stay, union time and functional outcomes.

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.

Locked Plating Versus Spiral Blade Retrograde Nailing in Supracondylar Femoral Fractures

2012 ◽  
Author(s):  
Soroush Assari ◽  
Alan Kaufman ◽  
Kurosh Darvish ◽  
Saqib Rehman ◽  
Jung Park ◽  
...  
Keyword(s):  
Bone Fractures ◽  
Weight Bearing ◽  
Femoral Fractures ◽  
The Elderly ◽  
Long Bone ◽  
Supracondylar Fractures ◽  
Locked Plating ◽  
Early Weight Bearing ◽  
Femur Fractures ◽  
Retrograde Femoral Nailing

Comminuted supracondylar femur fractures in the elderly are often treated with either retrograde femoral nailing or locked plating. Early weight-bearing is typically restricted after fixing supracondylar fractures, thereby impairing the patient’s mobilization. In general, surgeons are more comfortable allowing early weight-bearing of long bone fractures after nailing rather than plating, but early studies of retrograde nails for supracondylar fractures using standard distal locking showed poor fixation compared with locked plating.

scholarly journals Load-Bearing Detection with Insole-Force Sensors Provides New Treatment Insights in Fragility Fractures of the Pelvis

2020 ◽  
Vol 9 (8) ◽  
pp. 2551 ◽  
Author(s):  
Daniel Pfeufer ◽  
Christopher A. Becker ◽  
Leon Faust ◽  
Alexander M. Keppler ◽  
Marissa Stagg ◽  
...  
Keyword(s):  
Weight Bearing ◽  
Lower Extremities ◽  
Early Mobilization ◽  
Fragility Fractures ◽  
Lower Limbs ◽  
Full Weight Bearing ◽  
Force Sensors ◽  
Aging Society ◽  
Fracture Patterns ◽  
New Treatment

Background: Due to an aging society, more and more surgeons are confronted with fragility fractures of the pelvis (FFPs). The aim of treatment of such patients should be the quickest possible mobilization with full weight-bearing. Up to now however, there are no data on loading of the lower extremities in patients suffering FFPs. We hypothesized to find differences in loading of the lower limbs. Methods: 22 patients with a mean age of 84.1 years were included. During gait analysis with insole-force sensors, loading on the lower extremities was recorded during early mobilization after index fracture. Results: Especially the average peak force showed differences in loading, as the affected limb was loaded significantly less {59.78% (SD ± 16.15%) of the bodyweight vs. 73.22% (SD ± 14.84%) (p = <0.001, effect size r = 0.58)}. Furthermore, differences in loading in between the fracture patterns of FFPs were observed. Conclusion: This study shows that it is possible to reliably detect the extremity load, with the help of an insole device, in patients presenting with fragility fractures of the pelvis. There is great potential to improve the choice and time of treatment with insole-force sensors in FFPs in future.

scholarly journals Pediatric Femoral Neck Fractures

2014 ◽  
Vol 13 (2) ◽  
pp. 198-204
Author(s):  
Ramji Lal Sahu
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
Weight Bearing ◽  
Medical Science ◽  
Delayed Union ◽  
Femoral Neck Fractures ◽  
Full Weight Bearing ◽  
Coxa Vara ◽  
Anatomical Reduction ◽  
Mean Time

Introduction: Femoral neck fractures are rare injuries in children, but the high incidence of long term complications make it an important clinical entity. The aim of this prospective study was to analyze the clinical outcomes of pediatric femur neck fractures. Methods: The study included 16 children (10 boys and 6 girls) who sustained femoral neck fractures and completed an average follow-up of 28 months. The children were treated with anatomical reduction and internal fixation with partially threaded cancellous screws. The outcomes were clinically and radio logically assessed for fracture healing, joint movements and implant failure. Results: The mean age of included patients was 10 years (range, 6 to 16 years) and the average followup was 28 months (range, 17 -48 months). Coxa- vara was the most common complication Other complications included nonunion associated with Partial a vascular necrosis and delayed union was seen in one case but later on it had been corrected. Two cases of slight coxa vara were seen radiologically but clinically patients had no problem in walking and daily activities. All children achieved union in a mean time of 10 weeks (range from 6 - 16 weeks) except two cases. Full weight bearing was possible in a mean time of 8.8 weeks. The results were excellent in 68.75% and good in 18.75% patients. Conclusions: We conclude that the early operation using anatomical reduction and internal fixation of pediatric femoral neck fracture offers the best results and provide early healing less complication with good results and is economical. DOI: http://dx.doi.org/10.3329/bjms.v13i2.18303 Bangladesh Journal of Medical Science Vol.13(2) 2014 p.198-204

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