Elastic Nailing for Pediatric Subtrochanteric and Supracondylar Femur Fractures

Abstract

Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

Titanium elastic nailing versus locking compression plating in school-aged pediatric subtrochanteric femur fractures

“…[ 1 , 9 , 10 ] With the development of surgical technology, the operative indication of TEN has gradually extended to the proximal femur 1/3 and subtrochanteric fractures. [ 3 , 11 ] However, several studies have demonstrated suboptimal results with fractures in the proximal third of the femur [ 1 , 9 ] and length-unstable fracture patterns. [ 3 , 12 ] In the series by Flynn et al, [ 1 ] the only patient with a poor Titanium Elastic Nails Outcome Score was an 11-year-old child with a proximal, oblique comminuted fracture that healed with 15 mm of shortening and 20° of varus angulation.…”

“…But according to their study, open plating and submuscular plating were not analyzed separately, which may amplify the excellent results. Parikh et al [ 11 ] recently demonstrated that the outcomes of 33 patients with subtrochanteric fractures in school-age treated by TEN were satisfactory. Major complications such as nonunion, malunion, or limb length discrepancy and other serious complications after operation were low.…”

“…The long-term follow-up showed a good prognosis, so the authors believed that considering TEN represents a safe and efficient option to treat subtrochanteric femur fractures in children. [ 11 ] Closed reduction combined with TEN fixation is less invasive when compared with open reduction and locking plate fixation. TEN fixation is our preferred method of stabilization for subtrochanteric femur fractures in younger children and children of lower body weight.…”

Elastic stable intramedullary nailing for fractures in children – specific applications

“…The indications of ESIN in humeral fractures vary depending on the fracture site: the proximal metaphysis or the diaphysis. In the fractures of the surgical neck of the humerus, ESIN is indicated because it reduces the period of immobilization required in the case of conservative treatment [ 6 , 9 – 12 ].…”

“…At the end of the operation, the nails are cut and hidden under the tegument, without causing local irritations, so as to be easily visible at the time of ablation [ 2 , 6 , 10 ].…”