Do demographic and perioperative parameters really affect the final outcomes of pediatric femur shaft fractures managed by elastic nails? A prospective study

Reddy, A. Varun Kumar; Pushpasekaran, Narendran; Singh, Jitendra Kumar; Verma, Gokul Chand; Palanisamy, Sathyamurthy

doi:10.1016/j.jor.2018.01.003

Cited by 7 publications

(8 citation statements)

References 14 publications

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“…It is important to return the child to the family environment as soon as possible, and to reduce the cost of care for the patient. 8,9 This will reduce the psychological negative effects of the child, as well as it will benefit the family and the child as social and economic 10,11…”

Section: Introductionmentioning

confidence: 99%

Titanium elastic nailing in pediatric femoral diaphyseal fractures in the age group of 6-15 years mid-term and long-term outcomes

Kayaokay¹,

Aktuğlu²

2018

Pak J Med Sci

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Objective:To evaluate the effectiveness of Titanium Elastic Nailing (TEN) used in the surgical treatment of pediatric femoral shaft fractures and the effect of the complications to the outcome. Another objective was to assess the changing of Limb Length Discrepancy (LLD) and angulation degree with prolonged follow-up time and to evaluate whether the patient had a functional problem because of this situation.Methods:Thirty children between the ages of 6 and 15 who had femur shaft fractures were evaluated. The times of operation, ambulation, bone union and follow-up were recorded. Post-operative complications were evaluated between 1996-2016 with at least 24 Months follow up.Results:The mean follow-up was 52.5 ± 49.0 months (range 24-240). The mean varus angulation was 3.2 ± 5.1 degrees. The length of the fracture side was approximately 0.71 ± 0.58 cm (range 0-2.09 cm) longer than the intact side. There were eight patients with LLD of 1-2 cm. There was no statistically significant relationship between the type, location, and age of fracture of the LLD (P> 0.05). It was evaluated according to Flynn’s criteria. According to this, 12 (40%) of the patients’ results were excellent, 14 (46.7%) were good, and four were poor.Conclusion:TEN is an effective, easy, fast treatment method and has minimal complications for the treatment of femoral shaft fractures in childhood. Most complications can be reduced by performing basic principles and technical directions. Although LLD is a common complication of childhood femur fractures, the disease does not present a functional problem in daily life.

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Section: Introductionmentioning

confidence: 99%

Titanium elastic nailing in pediatric femoral diaphyseal fractures in the age group of 6-15 years mid-term and long-term outcomes

Kayaokay¹,

Aktuğlu²

2018

Pak J Med Sci

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“…Xu et al compared the fixation of subtrochanteric fractures in children with FIN and locking plates and found two methods can result in good functional outcomes, and the ranges of motion and neck-shaft angle of the affect limb were almost the same as those of the unaffected side in both methods [17]. Reddy et al presented a series of cases treated with FINs and showed that fracture located in the proximal region of the femur presented satisfactory outcome at end of 12 months [25]. Nevertheless, the number of cases was small, and restrictions of activities were recommended post-operatively [25].…”

Section: Discussionmentioning

confidence: 99%

“…Reddy et al presented a series of cases treated with FINs and showed that fracture located in the proximal region of the femur presented satisfactory outcome at end of 12 months [25]. Nevertheless, the number of cases was small, and restrictions of activities were recommended post-operatively [25]. Conversely, other authors found that plates are better implants for proximal femoral fractures than flexible nails [15,16,17].…”

Section: Discussionmentioning

confidence: 99%

“…Os relatos de maiores complicações das hastes elásticas nas fraturas subtrocantéricas encontrados por Li et al (2013) (REDDY et al, 2018). É válido mencionar, entretanto, que nesse trabalho o número de casos foi pequeno e houve necessidade de restringir a mobilidade pós-operatória.…”

Section: Métodos Dos Elementos Finitos (Mef)unclassified

“…É válido mencionar, entretanto, que nesse trabalho o número de casos foi pequeno e houve necessidade de restringir a mobilidade pós-operatória. Desta forma, a fixação com hastes é técnica menos invasiva e adequada para crianças de menor peso corporal, enquanto que a placa infantil bloqueada é fixação mais rígida e está associada à menor taxa de complicações como perda da redução (XU et al, 2018;REDDY et al, 2018).…”

Section: Métodos Dos Elementos Finitos (Mef)unclassified

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Hastes intramedulares flexíveis para fixação de fraturas subtrocantéricas de fêmur simuladas em modelos pediátricos: avaliação da estabilidade mecânica e método dos elementos finitos

Cruz¹

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pelas sugestões e pelo apoio na realização deste trabalho.Aos funcionários do Laboratório de Bioengenharia da FMRP-USP, Maria Terezinha de Moraes, Reginaldo Trevilato da Silva e Francisco Carlos Mazzucatto, pela amizade e disposição em ajudar. À Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) pelo apoio financeiro aos projetos de pós-graduação.Ao amigo e colega de pós-graduação Caio Toledo, pelo companheirismo durante toda esta etapa.Aos meus pais, Josilda e Mário Jorge, pela dedicação incansável na minha formação médica e humana, em especial à minha mãe, espelho de força, garra e competência na busca do aprendizado.Aos meus irmãos Mara e Marcelo, por estarem sempre juntos torcendo pelo meu sucesso.À Carla, pelo amor, paciência, companheirismo e incentivo. Obrigado por todos os sonhos compartilhados.A Deus, por tudo que Ele tem me permitido vivenciar.Palavras-chave: Fraturas do fêmur. Fixação intramedular de fraturas. Mecânica. Análise de Elementos Finitos.

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Fracture characteristics predict suboptimal alignment in preschool femoral shaft fractures treated with spica casting: a retrospective chart review

Misaghi

Mahmoud

Arkader

et al. 2020

Current Orthopaedic Practice

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Background: The authors aimed to identify the incidence of suboptimal alignment in preschool-aged children with diaphyseal femoral fractures treated with closed reduction and spica casting. We also sought to identify possible risk factors leading to suboptimal final alignment and the number of children initially treated by spica casting who needed revision surgery. Methods: This study retrospectively reviewed 132 cases of pediatric (age 3 to 6 yr) femoral shaft fractures treated with closed reduction and spica casting between January 2005 and October 2016. We evaluated whether age, weight, sex, mechanism of injury, fracture pattern, location, shortening, and angulation led to either acceptable or suboptimal fracture alignment at final radiographic follow-up. Results: Eighty-five patients (64.4%) healed in acceptable alignment, and 47 (35.6%) healed in unacceptable alignment. Higher energy injury patterns (transverse and comminuted) were more likely to result in suboptimal alignment at healing than lower energy patterns (oblique and spiral) (P=0.049). Proximal fractures trended towards more unfavorable results than other sites (P=0.068). Three independent risk factors for suboptimal alignment were identified including higher energy injury, initial coronal angulation greater than 8 degrees, and proximal fracture location. We determined a 99% chance of unacceptable alignment with three risk factors. We had a 9.8% (13 of 132 patients) return to operating room rate including 11patients for loss of reduction and two for cast soiling. Conclusions: Certain preschool-aged children with femoral fractures are at higher risk for suboptimal alignment after spica cast treatment. In higher risk cases, it may be reasonable to consider operative intervention and early mobilization instead of closed reduction and spica casting. Level of Evidence: Level IV.

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Do demographic and perioperative parameters really affect the final outcomes of pediatric femur shaft fractures managed by elastic nails? A prospective study

Cited by 7 publications

References 14 publications

Titanium elastic nailing in pediatric femoral diaphyseal fractures in the age group of 6-15 years mid-term and long-term outcomes

Titanium elastic nailing in pediatric femoral diaphyseal fractures in the age group of 6-15 years mid-term and long-term outcomes

Hastes intramedulares flexíveis para fixação de fraturas subtrocantéricas de fêmur simuladas em modelos pediátricos: avaliação da estabilidade mecânica e método dos elementos finitos

Fracture characteristics predict suboptimal alignment in preschool femoral shaft fractures treated with spica casting: a retrospective chart review

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