scholarly journals Associated injury complicated by pediatric lower limb shaft fractures and clinical efficacy of flexible stainless-steel intramedullary nailing in children less than 15 years old

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Shuichi Miyamoto ◽  
Makoto Otsuka ◽  
Fumio Hasue ◽  
Takayuki Fujiyoshi ◽  
Koushirou Kamiya ◽  
...  
Keyword(s):  
Stainless Steel ◽  
Intramedullary Nailing ◽  
Lower Limb ◽  
Fracture Site ◽  
Associated Injuries ◽  
Cerebral Contusion ◽  
Visceral Injury ◽  
Associated Injury ◽  
Shaft Fractures

Although pediatric lower limb shaft fractures are common, little is known about associated injuries. The purpose of this study was to examine associated injuries complicated by pediatric lower limb shaft fractures and the efficacy of surgical treatment using a flexible stainless-steel intramedullary Ender nail in children less than 15 years old. This is a retrospective review of 29 children younger than 15 years old who were diagnosed with femoral or tibial shaft fractures and treated using Ender nails from 2005 to 2016. Baseline data, etiology, associated injuries, fracture site and patterns, operative and post-operative assessment were evaluated. The average age of the patients was 9.0 years, and mean follow-up was 18.2 months. Eleven patients (79%) had associated injury. At the final follow up, six patients (43%) sustained complications associated with the insertion area of the nail. There was no evidence of deep infection or nonunion at either fracture site. The clinical results were excellent in 10 (67%) fractures, and good in 5 (33%) fractures, based on the modified Flynn criteria. Almost all patients with a femoral fracture had an associated injury including abdominal visceral injury, cerebral contusion or other fractures. This study indicated good clinical and functional outcomes. On the other hand, the minor complications rate was high. Nevertheless, elastic stable intramedullary nailing recently has become available in Japan, and a prospective and comparative study is needed.

scholarly journals Randomized Controlled Trial of the Clinical Recovery and Biodegradation of Polylactide-co-glycolide Implants Used in the Intramedullary Nailing of Children’s Forearm Shaft Fractures with at Least Four Years of Follow-Up

2021 ◽  
Vol 10 (5) ◽  
pp. 995
Author(s):  
Marja Perhomaa ◽  
Tytti Pokka ◽  
Linda Korhonen ◽  
Antti Kyrö ◽  
Jaakko Niinimäki ◽  
...  
Keyword(s):  
Intramedullary Nailing ◽  
Controlled Trial ◽  
Long Term Outcomes ◽  
Intramedullary Nails ◽  
Metal Implants ◽  
Shaft Fractures ◽  
Fractures In Children ◽  
Significant Difference

The preferred surgical fixation of forearm shaft fractures in children is Elastic Stable Intramedullary Nailing (ESIN). Due to known disadvantageous effects of metal implants, a new surgical method using biodegradable polylactide-co-glycolide (PLGA) intramedullary nails has been developed but its long-term outcomes are unclear. The aim of this study was to compare the long-term outcomes of Biodegradable Intramedullary Nailing (BIN) to ESIN and assess the biodegradation of the study implants via magnetic resonance imaging (MRI). The study population of the prospective, randomized trial consisted of paediatric patients whose forearm shaft fractures were treated with BIN (n = 19) or ESIN (n = 16). Forearm rotation at minimally four years’ follow-up was the main outcome. There was no clinically significant difference in the recovery of the patients treated with the BIN as compared to those treated with the ESIN. More than half of the implants (57.7%, n = 15/26) were completely degraded, and the rest were degraded almost completely. The PLGA intramedullary nails used in the treatment of forearm shaft fractures in this study resulted in good function and anatomy. No unexpected disadvantages were found in the degradation of the implants. However, two implant failures had occurred in three months postoperatively.

scholarly journals Suprapatellar versus infrapatellar approaches in the treatment of tibia intramedullary nailing ： A retrospective cohort study

2019 ◽  
Author(s):  
Yiliang Cui ◽  
Xingyi Hua ◽  
Florian Schmidutz ◽  
Jian Zhou ◽  
Zongsheng Yin ◽  
...  
Keyword(s):  
Blood Loss ◽  
Intramedullary Nailing ◽  
Functional Outcomes ◽  
Operation Time ◽  
Tibial Shaft ◽  
Shaft Fractures ◽  
Significant Difference ◽  
Special Surgery ◽  
Tibial Shaft Fractures

Abstract Background: Tibial shaft fractures are routinely managed with intramedullary nailing (IMN). An increasingly accepted technique is the suprapatellar (SP) approach. The purpose of this study was to compare the clinical and functional outcomes of knee joint after tibia IMN through an suprapatellar (SP) or traditional infrapatellar (IP) approach. Methods: Retrospective analysis was performed in patients with tibial shaft fractures that were treated with IMN through a SP or IP approach between 01/01/2014 and 31/12/2016. The clinical and functional outcomes of the knee were assessed with the Hospital for Special Surgery (HSS) Knee Score. Secondary outcomes included the operation time and intraoperative blood loss. Results: A total of 50 patients/fractures (26 IP and 24 SP) with a minimum follow-up of 15 months were evaluated. All fractures were OTA 42. No significant differences were found between the two groups in age, gender, side of fractures, operation time, intra-operative blood loss, and follow-up time. No significant difference was seen in HSS score ( P = 0.62) between them. Sub analysis of all the HSS components scores revealed no significant differences between pain ( P = 0.57), the stand and walk ( P = 0.54), the need for walking stick ( P = 0.60) and extension lag ( P = 0.60). The other HSS components showed full scores (IP 10 vs. SP 10) in both approaches, including muscle force, flexion deformity and stability components. The range of motion (ROM) component score was superior in the IP group ( P = 0.04) suggesting a higher ROM. Conclusions: Both SP and IP approach results in equivalent overall HSS knee scores. However, for the HSS component, the IP approach was superior to SP approach regarding the ROM.

scholarly journals Suprapatellar versus infrapatellar approaches in the treatment of tibia intramedullary nailing: a retrospective cohort study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Yiliang Cui ◽  
Xingyi Hua ◽  
Florian Schmidutz ◽  
Jian Zhou ◽  
Zongsheng Yin ◽  
...  
Keyword(s):  
Blood Loss ◽  
Intramedullary Nailing ◽  
Functional Outcomes ◽  
Operation Time ◽  
Tibial Shaft ◽  
Shaft Fractures ◽  
Significant Difference ◽  
Special Surgery ◽  
Tibial Shaft Fractures

Abstract Background Tibial shaft fractures are routinely managed with intramedullary nailing (IMN). An increasingly accepted technique is the suprapatellar (SP) approach. The purpose of this study was to compare the clinical and functional outcomes of knee joint after tibia IMN through an suprapatellar (SP) or traditional infrapatellar (IP) approach. Methods Retrospective analysis was performed in patients with tibial shaft fractures that were treated with IMN through a SP or IP approach between 01/01/2014 and 31/12/2016. The clinical and functional outcomes of the knee were assessed with the Hospital for Special Surgery (HSS) Knee Score. Secondary outcomes included the operation time and intraoperative blood loss. Results A total of 50 patients/fractures (26 IP and 24 SP) with a minimum follow-up of 15 months were evaluated. All fractures were OTA 42. No significant differences were found between the two groups in age, gender, side of fractures, operation time, intra-operative blood loss, and follow-up time. No significant difference was seen in HSS score (P = 0.62) between them. Sub analysis of all the HSS components scores revealed no significant differences between pain (P = 0.57), the stand and walk (P = 0.54), the need for walking stick (P = 0.60) and extension lag (P = 0.60). The other HSS components showed full scores (IP 10 vs. SP 10) in both approaches, including muscle force, flexion deformity and stability components. The range of motion (ROM) component score was superior in the IP group (P = 0.04) suggesting a higher ROM. Conclusions Both SP and IP approach results in equivalent overall HSS knee scores. However, for the HSS component, the IP approach was superior to SP approach regarding the ROM.

Percutaneous Intramedullary Fixation of Metacarpal Shaft Fractures

1999 ◽  
Vol 24 (1) ◽  
pp. 76-79 ◽  
Author(s):  
A. A. FARAJ ◽  
T. R. C. DAVIS
Keyword(s):  
Fracture Site ◽  
Intramedullary Fixation ◽  
Carpometacarpal Joint ◽  
Small Window ◽  
Shaft Fractures ◽  
Metacarpal Shaft ◽  
K Wires ◽  
Angular Deformities

Twenty-two displaced metacarpal shaft fractures in 19 patients were stabilized with multiple intramedullary K-wires. These were inserted percutaneously through a small window in the base of the metacarpal and were buried in the bone. No external splintage was routinely used postoperatively and all patients were encouraged to mobilize their fingers immediately: formal physiotherapy was not usually required. All the fractures that we were able to follow-up united, but the K-wires bent at the fracture site in two instances, producing 20° angular deformities. The buried K-wires had to be removed in one instance as a result of protrusion into the carpometacarpal joint.

scholarly journals Definitive Treatment of Femoral Shaft Fractures: Comparison between Anterograde Intramedullary Nailing and Monoaxial External Fixation

2019 ◽  
Vol 8 (8) ◽  
pp. 1119 ◽  
Author(s):  
Gianluca Testa ◽  
Andrea Vescio ◽  
Domenico Costantino Aloj ◽  
Giacomo Papotto ◽  
Luigi Ferrarotto ◽  
...  
Keyword(s):  
External Fixation ◽  
Intramedullary Nailing ◽  
Gold Standard ◽  
Femoral Shaft ◽  
Bone Union ◽  
Definitive Treatment ◽  
Ao Classification ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures

Background: Femoral shaft fractures result from high-energy trauma. Despite intramedullary nailing (IMN) representing the gold standard option of treatment, external fixation (EF) can be used temporarily for damage control or definitively. The purpose of this study is to compare two different options, anterograde IMN and monoaxial EF, for the treatment of femoral shaft fractures. Methods: Between January 2005 and December 2014, patients with femoral shaft fractures operated on in two centers were retrospectively evaluated and divided into two groups: the IMN group (n = 74), and the EF group (n = 73). For each group, sex; laterality; age; and AO classification type mean follow-up, mean union time, and complications were reported. Results: Both groups were found to have no statistical differences (p > 0.05) in sex, laterality, age, and AO classification types. In the IMN group the average surgery duration was 79.7 minutes (range 45–130). The average time for bone union was 26.9 weeks. Major complications occurred in 4 (5.4%) patients. In the EF group the average follow-up duration was 59.8 months (range 28–160). The average time for bone union was 24.0 weeks. Major complications occurred in 16 (21.9%) patients. Conclusions: IMN is the gold standard for definitive treatment of femoral shaft fractures. In patients with severe associated injuries, EF should be a good alternative.

Sign in / Sign up

Export Citation Format

Share Document