ASSESSMENT OF RESULTS OF TREATMENT OF PAEDIATRIC FEMORAL DIAPHYSEAL FRACTURES WITH TITANIUM ELASTIC NAILS

2021 ◽  
pp. 75-76
Author(s):  
Shamir Rahman ◽  
Nafees Fatima ◽  
Vijay Kumar ◽  
Debarshi Jana
Keyword(s):  
Femoral Fractures ◽  
Control Group ◽  
Age Group ◽  
Femur Fractures ◽  
Results Of Treatment ◽  
Operative Evaluation ◽  
Diaphyseal Fractures ◽  
Elastic Nails ◽  
Surgical Modality ◽  
Distal Fracture

Introduction: Femoral fractures are among the most common fractures of long bones. The management of pediatric femur fractures depends basically on the age group of the child although the age of bone and size of the child also determines the treatment choice. The choice of management may also be determined by surgical experience and local trends in practice. Study aimed to assess the results of treatment of paediatric femoral diaphyseal fractures with titanium elastic nails. Material And Methods: The study was conducted at Orthopaedics Department of PMCH, Patna, Bihar. A total of 22 patients with closed shaft femur fractures and age ranging between 5-16 years scheduled to undergo treatment with titanium elastic nails were selected for the study. Children with open fractures, outside this age group with concomitant head injury, bilateral femur fracture or associated fracture of either limb whose xation was done after 7 days were excluded from the study. No control group was used. They were treated by retrograde TENS xation using two nails of equal diameter for each fracture. Pre-operative evaluation includes full length radiograph of the fractured femur both antero–posterior (A–P) and lateral views. Results: In the present study, 22 patients with closed shaft femur fractures were treated with titanium elastic nails. The mean age of the patient was 13.23 years. We observed that in regards to fracture location, proximal fracture was seen in 5 patients, midshaft fracture in 14 patients and distal fracture in 3 patients. However, in regards to pattern of location, transverse fracture was seen in 6 patients, oblique fracture in 8 patients, spiral fracture in 5 patients and comminuted fracture in 3 patients. Conclusion: From this study we can conclude that Intramedullary nailing of the pediatric femoral diaphyseal fractures using titanium elastic nail is an effective surgical modality, with advantages of minimal incisional scar, minimal soft tissue damage, with early union time and excellent union rates, and without affecting shoulder and elbow function.

scholarly journals Internal fixation of pediatric shaft femur fractures by titanium elastic nails: clinical and radiological study

2016 ◽  
Vol 2 (4) ◽  
pp. 299
Author(s):  
Manoharan M. ◽  
Mahapatra S.
Keyword(s):  
Weight Bearing ◽  
Joint Stiffness ◽  
Femoral Fractures ◽  
Full Weight Bearing ◽  
Age Group ◽  
Femur Fractures ◽  
Pediatric Age Group ◽  
Elastic Nails ◽  
Elastic Nail ◽  
Operative Fixation

<p class="abstract"><strong>Background:</strong> Management of diaphyseal femoral fractures in the pediatric age group is challenging. There has been a demand worldwide for operative fixation<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> Twelve children (7 boys, five girls) aged 6-16 years with diaphyseal femoral fractures (12 fractures, one in each) was stabilized with titanium elastic nail system (TENS). Patients underwent surgery within a week days of their injury. The results were evaluated using Flynn's Scoring system. Identical two nails were used in each fracture.<strong></strong></p><p class="abstract"><strong>Results:</strong> All 12 patients were available for evaluation and follow-up for a mean duration of 24 months (14-34 months). Radiological union in all cases was seen at a mean duration of 8 weeks. Full weight bearing was possible at a mean duration of 10 weeks (8-12 weeks). The results were excellent in 8 patients (67%) and satisfactory in 4 patients (33%).  Complications that occurred were infection (2 cases), knee joint stiffness (4 cases), angulation &lt;10 degrees (1 case), and shortening less than 10 mm (2 cases)<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Intramedullary fixation by TENS is an effective, time-tested treatment of fracture of the femur in patients of the 6-16 years age group<span lang="EN-IN">.</span></p>

scholarly journals Changes in Indicators of Microcirculation in the Early Postoperative Period in the Treatment of Diaphyseal Fractures of the Shin Bones Using a Plate with Limited Contact

2019 ◽  
Vol 4 (3) ◽  
pp. 58-62
Author(s):  
A. I. Plakhov ◽  
L. I. Kolesnikova ◽  
L. I. Korytov ◽  
V. G. Vinogradov ◽  
M. A. Darenskaya
Keyword(s):  
Postoperative Period ◽  
Lower Limb ◽  
Blood Circulation ◽  
Early Period ◽  
Metal Plate ◽  
Early Postoperative Period ◽  
Control Group ◽  
Doppler Flowmetry ◽  
Results Of Treatment ◽  
Diaphyseal Fractures

Background. Unsatisfactory results of treatment, such as delayed consolidation and non-fusion of fractures, the formation of false joints and limb bone defects, have no tendency to decrease. We can assume that one of the leading factors of complications in traumatology is a violation of microcirculation in the affected segment of the limb.Aims. To identify patterns of changes in the parameters of the microcirculatory bed of the damaged segment of the lower limb when fixing bone fragments with a plate with limited contact in the early period after surgery.Materials and methods. In 25 patients, we studied four parameters of microcirculation of the lower limb segment with application of laser Doppler flowmetry. The control group consisted of 25 healthy volunteers, comparable in age and sex with the study group.Results. We found that in the early postoperative period (from the first to the 10th day after the surgery) in patients with diaphyseal fractures of the tibia operated with metal plate with limited contact there was an increase in microcirculation by 75.69 %, an increase in the proportion of the nutritive component of microcirculation compared to the shunt fraction by 24.64 %, as well as an increase in more than one ratio of the amplitude of the heart and respiratory range. All of that indicates a local circulatory disorder in the nutritive arterial hyperemia. We note that the increase in the amplitude of the respiratory component by 17.22 % and the equality of the amplitude of the cardiac range compared with the control group indicate violations of local blood circulation by the type of venous stagnation.Conclusion. On the basis of the results obtained, we note that patients with diaphyseal fractures of the shin bones treated with metal osteosynthesis with a plate with limited contact in the early postoperative period develop a violation of local blood circulation in the stagnant-hyperemic type.

scholarly journals Comparison of Titanium Elastic Nailing and End-threaded Intramedullary Pinning for Distal Femoral Fractures in Young Dogs

2021 ◽  
Author(s):  
Harmanpreet Singh Sodhi ◽  
Ashwani Kumar ◽  
Arun Anand ◽  
Vandana Sangwan ◽  
Opinder Singh
Keyword(s):  
Stainless Steel ◽  
Functional Outcome ◽  
Weight Bearing ◽  
Femoral Fractures ◽  
Titanium Implants ◽  
Early Weight Bearing ◽  
Femur Fractures ◽  
Elastic Nails ◽  
Group 2 ◽  
Group 1

Background: Femur fractures are common in immature dogs. As compared to stainless steel, titanium implants are lighter and allow controlled micro-motion at the site of fracture that stimulates early callus formation by limiting stress shielding. Cited literature reports successful clinical use of titanium elastic nails for the stabilization of long bone fractures in young human patients; however, there is paucity of information on this technique is dogs. This study was planned with an objective to compare titanium elastic nails (TENS) and single end-threaded pin for the management of femoral fractures in young dogs. Methods: The study included 20 clinical cases (10 male and 10 female) of dogs suffering from distal femoral fracture with a mean ± SD age of 5.70 ± 5.60 month, body weight 11.09 ± 4.48 Kg since 3.05 ± 2.35 days. The cases were divided into 2 groups; using TENS (n=10; group 1) and stainless steel end-threaded intramedullary pin (n=10; group 2). Result: Group 1 dogs demonstrated better fracture reduction score, early and uniform callus and better implant stability as compared to group 2, radiographically. Early weight bearing and minimum postoperative complications with better functional outcome including joint mobility was reported in group 1. In conclusions, TENS is superior fracture fixation technique for the repair of supracondylar or distal third femur fractures in young dogs with better functional outcome, minimal stiffness of stifle joint and early weight bearing, in comparison to single end threaded intramedullary pin.

scholarly journals Comparative study of the outcome of pediatric femur diaphyseal fractures treated with titanium elastic nails vs. compression plates

2016 ◽  
Vol 3 (1) ◽  
pp. 80
Author(s):  
Angad Jolly ◽  
Neelanagowda V. Patil ◽  
Rahul Bansal ◽  
Veeresh Pattanshetti
Keyword(s):  
Knee Joint ◽  
Internal Fixation ◽  
Significant Loss ◽  
Fixation Method ◽  
Wound Complications ◽  
Angular Deformity ◽  
Femur Fractures ◽  
Diaphyseal Fractures ◽  
Elastic Nails ◽  
Compression Plating

<p class="abstract"><strong>Background:</strong> A variety of methods have been described for the management of femur diaphyseal fractures in children between ages of 5 to 12 years. Some of the techniques include closed reduction and internal fixation (CRIF) with elastic nails, open reduction and internal fixation (ORIF) with compression plates, external fixators and skeletal traction with spica casting. This study was done to compare the outcome and complications of diaphyseal femur fractures in pediatric age treated with CRIF with Titanium elastic nails vs. ORIF with compression plates<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> The study was a prospective, clinical study.  A total of 60 patients were studied. 30 patients were treated with CRIF with titanium nails and 30 patients were treated with ORIF with compression plates. Every patient operated was followed up at 3 weeks, 6 weeks, 3 months, 6 months and 3 monthly thereafter until implant removal.<strong></strong></p><p class="abstract"><strong>Results:</strong> Only 1 wound healing complication was noted in the TENS nail group which was skin irritation at the site of pin insertion. In the compression plating group, 6 patients developed wound complications, including superficial infections, deep infections and keloids. The range of movements at knee joint in the two groups was compared.  Only 1 patient had a significant loss of flexion with ROM of less than 100 degrees in the TENS nail group. In the plating group 4 patients had a significant loss of flexion with ROM of less than 100 degrees. Limb length discrepancies were seen in 3 patients in the TENS nail group whereas the compression plating group showed 1 patient. 2 patients in the TENS group developed an angular deformity due to premature weight bearing.  3 patients in the compression plating group developed deformities at the fracture site. The average time for fracture union in the compression plate group was 10.7 weeks and was 14.7 weeks in the patients treated with TENS nail<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> No single fixation method can be considered superior in all types and patterns of pediatric diaphyseal femur fractures. Titanium elastic nails can be considered a better implant for treating pediatric femur fractures when compared to compression plates due to the lesser rates of surgical wound complications, better range of movements at knee joint and overall lesser complication rate as was recorded in this study<span lang="EN-IN">.</span></p>

scholarly journals (P1-105) Osteosynthesis of Children with Femur Fractures from Traffic Accidents

2011 ◽  
Vol 26 (S1) ◽  
pp. s133-s133
Author(s):  
V.M. Rozinov ◽  
S.I. Jandiev ◽  
V.I. Petlakh
Keyword(s):  
Traffic Accidents ◽  
Functional Results ◽  
Infectious Complications ◽  
Optimum Treatment ◽  
Number Of Children ◽  
Intramedullary Osteosynthesis ◽  
Femur Fractures ◽  
Fractures In Children ◽  
Diaphyseal Fractures ◽  
Elastic Nails

IntroductionThe growing number of children suffering polytrauma from traffic accidents dictates the expansion of the indications for osteosynthesis. Elastic-stable intramedullary osteosynthesis (ESIN) is the optimum treatment of fractures of long bones in children.MethodsClosed intramedullary osteosynthesis of diaphyseal femur fractures with flexible nails was performed in 74 patients (76 fractures) during 2006–2010. The patients were children ages 1–8 years. Titanium elastic nails (TEN) (Synthesis, Switzerland) were used in the procedures. AO Foundation recommendations were adhered to when selecting the size of the implant (i.e., diameter approximately 1/3 the diameter of the femur medullar canal at its narrowest part).ResultsThere was a prevalence (n = 53) of simple fractures (Ð3 by AO classification) in this group of patients. Sixteen children had Ð2-type fractures, five with spiral (Ð1), and two with slanting (Ð2) fractures. There were no type Ð1 or Ð3 complex fractures in this group. Good functional results of closed intramedullary osteosynthesis with TEN at diaphyseal fractures of the femur in children with isolated and associated damages were achieved. There were no post-operative complications. This method provided stability of osteosynthesis, which allows activating patients in the short- term, i.e., during the post-operative period.ConclusionTreating femur fractures in children with ESIN provides optimum treatment of polytrauma. Osteosynthesis without exposure to the area of damage, and the early activation of children can prevent infectious complications and contractures.

scholarly journals ¿Tardan más en consolidar las fracturas asociadas a bifosfonatos? [Is the time for consolidation of fractures associated with bisphosphonates higher?]

2019 ◽  
Vol 84 (4) ◽  
pp. 320-327
Author(s):  
Fernando Vanoli ◽  
Luciano Gentile ◽  
Alejandra Beatriz Juarez ◽  
Marcos Sahid Eluani ◽  
Ignacio Pioli ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Femoral Fractures ◽  
Healing Time ◽  
Low Energy ◽  
Control Group ◽  
Cephalomedullary Nail ◽  
Atypical Femoral Fractures ◽  
Treatment Of Osteoporosis ◽  
Femur Fractures ◽  
Atypical Femur Fractures

Introducción: Los bifosfonatos evolucionaron como el pilar para el tratamiento de la osteoporosis, reduciendo la incidencia de fracturas. Recientemente, varias publicaciones describieron la aparición de fracturas atípicas de fémur de baja energía asociadas con el uso de bifosfonatos. El objetivo de este estudio fue evaluar el tiempo promedio de consolidación de las fracturas atípicas de fémur asociadas al tratamiento con bifosfonatos comparado con el de un grupo de control. Materiales y Métodos: Se evaluó, en forma retrospectiva, a 34 mujeres (edad promedio 74 años) con fracturas atípicas; 16 de ellas habían recibido bifosfonatos, al menos, por cinco años. Fueron tratadas entre 2006 y 2017, y estabilizadas con un clavo cefalomedular. Este grupo fue comparado con un grupo de control de similares características. Resultados: Veintidós tenían fracturas subtrocantéricas y 12, diafisarias. El 14% de las que tomaron bifosfonatos y fueron operadas requirió una revisión frente al 5,5% del grupo de control. El tiempo promedio de consolidación fue mayor en las tratadas con bifosfonatos (8.5 vs. 6 meses), con una diferencia estadísticamente significativa (p <0,001).Conclusiones: El beneficio del tratamiento con bifosfonatos en la prevención de fracturas es superior al riesgo de fracturas atípicas; sin embargo, es importante evaluar la relación riesgo-beneficio en cada paciente al comienzo y durante el tratamiento, teniendo en cuenta que, pese a esto, el tiempo de curación es más largo. AbstractIntroduction: Bisphosphonates evolved as the mainstay for the treatment of osteoporosis, reducing the incidence of fractures. Recently, several publications described the occurrence of low-energy atypical femur fractures associated with the use of bisphosphonates. The objective of this work was to study the average time of consolidation of the atypical femoral fractures caused by the consumption of bisphosphonates compared with a control group.Materials and Methods: We retrospectively evaluated 34 patients with atypical femoral fractures of which 16 patients had undergone treatment with bisphosphonates for at least 5 years, treated between 2006 and 2017, and stabilized with a cephalomedullary nail, and were compared with a control group of similar characteristics.Results: All the patients were female. The average age was 74 years. 22 presented subtrochanteric fractures while 12 were diaphyseal. 14% of the subjects who took bisphosphonates and received surgical treatment, required a revision versus 5.5% of the control group. The average time of consolidation was higher in those treated with bisphosphonates (8.5 months vs. 6 months), this being statistically significant (p <0.001).Conclusions: The benefit of treatment with bisphosphonates in the prevention of fractures is greater than the risk of atypical fractures. However, it is important to evaluate the risk-benefit in each patient at the beginning and the duration of the treatment, taking into account that despite this, the healing time is longer.   

scholarly journals Classification, fixation techniques, complications and outcomes of femur fractures in dogs and cats: 61 cases (2015-2016)

2018 ◽  
Vol 48 (6) ◽  
Author(s):  
Renato do Nascimento Libardoni ◽  
Diego da Costa ◽  
Felipe Barretos Menezes ◽  
Lucas Geraldo Cavalli ◽  
Luís Fernando Pedrotti ◽  
...  
Keyword(s):  
Femoral Fractures ◽  
Tension Band ◽  
Bone Plates ◽  
Fixation Methods ◽  
Femur Fractures ◽  
Distal Epiphysis ◽  
Significant Difference ◽  
Epiphyseal Fractures ◽  
Fixation Techniques ◽  
Diaphyseal Fractures

ABSTRACT: The aim of this study was to retrospectively evaluate the frequency of femur fractures in dogs and cats in the routine of a school hospital, determining their classification, fixation methods, complications, and outcomes. A total of 61 animals, 50 (82.0%) dogs and 11 (18.0%) cats, had femoral fractures that were submitted to osteosynthesis. Sixty-two femoral fractures were evaluated. Single fractures in the distal epiphysis (n=25) were the most frequent (P=0.0001). Intramedullary pins were used in association with cerclage and tension band for osteosynthesis in proximal fractures. In diaphyseal fractures, bone plates and screws, two intramedullary pins (insulated or with cerclage) and Tie-In configuration were used. In distal fractures, modified Rush intramedullary pins, cross pins and Tie-In configuration were used. Comparing complication frequencies at fracture sites that required reintervention after osteosynthesis, a significant difference was observed (P=0.0253) between the diaphyseal (31.25%) and distal (7.14%) fractures independent of the technique used. We concluded that distal epiphyseal fractures were the most frequent in the routine of a school hospital. Distal epiphyseal fractures presented a lower frequency of complications for consolidation when treated with modified Rush intramedullary pins or crossed pins.

scholarly journals Treatment of Proximal Femoral Fractures in Patients with COVID-19

2021 ◽  
Vol 27 (3) ◽  
pp. 9-18
Author(s):  
Konstantin S. Egorov ◽  
Valery V. Strizheletsky ◽  
Igor G. Ivanov ◽  
Valentin A. Neverov ◽  
Natalia V. Siverskaya ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Proximal Femur ◽  
Femoral Fractures ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Results Of Treatment ◽  
Neck Fracture ◽  
Coronavirus Infection

Background. In relation with the COVID-19 new coronavirus infection epidemic that began in Russia in the spring of 2020, a completely new group of patients appeared: patients whose coronavirus infection was combined with the proximal femur fractures. In the course of practical work, hospital doctors had to gain experience in treating these complex patients, solve new organizational and medical tasks. The aim of the study was to evaluate the results of treatment of patients with the proximal femur fractures in combination with coronavirus infection in a covid hospital at the hospital stage, 30-day and 6-month terms. Materials and Methods. The retrospective study is based on the collection and generalization of data from 64 patients with the proximal femur fractures in combination with confirmed coronavirus infection who underwent inpatient treatment from 16.03.2020 to 31.05.2021. 38 (59.4%) patients had a femoral neck fracture, 26 (40.6%) had a fracture of the trochanter region. Forty (62.5%) patients underwent surgical treatment (hip replacement was performed in 23 cases, osteosynthesis was performed in 17 cases), 24 (37.5%) patients did not undergo surgery. Results. With conservative treatment, the hospital mortality rate was 41.6%, the 30-day mortality rate was 72.7%, and the 6 month mortality rate was 95.5%. During surgical treatment, the hospital mortality rate was 5.0% (2 patients died). Early postoperative complications were detected in 5 (12.5%) patients. Thirty-one (77.5%) patients walked or stood with a walker on their own at the time of discharge; 7 (17.5%) patients could not be activated. The thirty-day mortality rate in the group of patients who underwent surgical treatment was 8.6%, and the 6-month mortality rate was 32.1%. Conclusion. Surgical treatment of patients with the proximal femur fractures in combination with coronavirus infection is much more difficult than the treatment of patients without infectious pathology. However, despite number of unresolved problems, surgical treatment of such patients is possible with good results and should be actively applied.

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