Fractures and Refractures After Femoral Locking Compression Plate Fixation in Children and Adolescents

Becker, Talia; Weigl, Daniel; Mercado, Eyal; Katz, Kalman; Bar‐On, Elhanan

doi:10.1097/bpo.0b013e318264496a

Cited by 17 publications

(20 citation statements)

References 27 publications

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“…However, we did not find varus, derotation, or shortening osteotomy in PFO to be associated with implant-related fractures. Although locking plates are thought to reduce the level of stress at the osteotomy site (Bottlang et al 2010, Becker et al 2012, neither the occurrence of an implant-related fracture nor the fracture site was found to be related to plate type in our study. Children with DDH always have a larger neck-shaft angle or anteversion angle in the proximal femur, especially those with complete dislocation.…”

Section: Discussioncontrasting

confidence: 76%

“…Although the rate is low, these complications or fractures prolong immobilization in children and sometimes require additional surgery. Few studies have investigated relations between implant-related fractures and sites of fractures or types of plates (Becker et al 2012, Jain et al 2012, Chung et al 2018. Jain et al (2012) reported that the femur is more likely to incur an implant-related fracture than are other bones, and suggested that the level of stress exerted by an implant can be high over short anatomic distances in the proximal femur.…”

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confidence: 99%

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Risk factors for implant-related fractures after proximal femoral osteotomy in children with developmental dysplasia of the hip: a case-control study

et al. 2020

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occurred at the osteotomy site (n = 13/15), while in those with the implant remaining, the fractures mostly occurred in the screw hole (n = 8/13). Interpretation-The type of PFO performed is not associated with implant-related fractures in children with DDH. Children with mild remodeling at the osteotomy site should be closely followed up, regardless of whether the hardware is removed, and high-intensity activity should not be permitted until moderate or extensive remodeling is confirmed. After PFO, the implants should be removed when solid union is achieved at the osteotomy site.

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Section: Discussioncontrasting

confidence: 76%

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confidence: 99%

Risk factors for implant-related fractures after proximal femoral osteotomy in children with developmental dysplasia of the hip: a case-control study

et al. 2020

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“…8 (12.7%) fractures were reduced percutaneously with an instrument within the fracture site but only visualized on fluoroscopy. The remaining 36 growth, implant failure, and fracture through screw holes [9,12,[17][18][19]. Flexible nailing, on the other hand, is theoretically limited to length-stable fractures in smaller patients, with greater risks of loss of reduction, malunion, and a longer time to full weight bearing as a result of decreased stability [12,20,21].…”

Section: Resultsmentioning

confidence: 99%

How Long Do We Need to Restrict Weight Bearing after Fixation of Pediatric Femur Fractures?

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et al. 2020

Int Arch Orthop Surg

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“…23 Although compression plates do provide increased fracture stability, the chances of refracture especially in the 1 st week after implant removal are high. 24 ORIF with compression plates is also notorious for the increased rates of infection, extensive soft tissue damage around the fracture and subsequent delayed fracture union. 25 The lesser rate of surgical wound related complications, lesser operative time, minimal blood loss and faster recovery with titanium nails used in the treatment of pediatric femur fractures as reflected in our study is also consistent in other similar studies and case series, making titanium elastic nailing the procedure of choice in fixation of pediatric femur fractures in the age group of 5 to 12 years.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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Background: 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.Methods: 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.Results: 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. Conclusions: 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.

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Fractures and Refractures After Femoral Locking Compression Plate Fixation in Children and Adolescents

Abstract: Level IV.

Cited by 17 publications

References 27 publications

Risk factors for implant-related fractures after proximal femoral osteotomy in children with developmental dysplasia of the hip: a case-control study

Risk factors for implant-related fractures after proximal femoral osteotomy in children with developmental dysplasia of the hip: a case-control study

How Long Do We Need to Restrict Weight Bearing after Fixation of Pediatric Femur Fractures?

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

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