Immediate Intramedullary Flexible Nailing of Open Pediatric Tibial Shaft Fractures

Pandya, Nirav K.; Edmonds, Eric W.

doi:10.1097/bpo.0b013e318270468b

Cited by 48 publications

(59 citation statements)

References 25 publications

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“…The authors believed this was largely due to the expedient administration of antibiotics in these patients within 6 hours of the injury, and meticulous soft tissue handling. 18 The advantage of flexible nails is that they are inserted at a position distinct from the traumatic wound, impart minimal damage to the surrounding soft tissue, and do not provide an infectious nidus from pin tracts. In comparison, Bartlett et al 28 found that 6 patients required free muscle flaps.…”

Section: Discussionmentioning

confidence: 99%

“…In a recent study of 14 open tibia fractures that underwent immediate flexible nailing and a control group of 12 closed tibia fractures, there was no significant difference in regards to the rate of infectious/wound complications. 18 Furthermore, all patients except 1 in this series underwent primary wound closure. With prompt antibiotic administration and meticulous soft tissue management, primary wound closure can often be performed.…”

Section: Flexible Nail Fixationmentioning

confidence: 99%

“…Traumatic brain injury is a major cause of morbidity and mortality in the pediatric and adolescent polytrauma population, 19 and the utilization of flexible nailing must be performed with caution to prevent pulmonary and neurological compromise. 18 Additional orthopaedic injuries should be sought out and treated as well.…”

Section: Initial Assessmentmentioning

confidence: 99%

“…18 A comprehensive workup should be performed to look for associated injuries, particularly closed head injury. Traumatic brain injury is a major cause of morbidity and mortality in the pediatric and adolescent polytrauma population, 19 and the utilization of flexible nailing must be performed with caution to prevent pulmonary and neurological compromise.…”

Section: Initial Assessmentmentioning

confidence: 99%

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Flexible Intramedullary Nailing of Unstable and/or Open Tibia Shaft Fractures in the Pediatric Population

Pandya

2016

Journal of Pediatric Orthopaedics

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Tibial shaft fractures are common injuries in the pediatric population, and can be treated conservatively the vast majority of the time. Yet, it is important to recognize that open and/or unstable tibial shaft fractures represent a different entity. Rigid intramedullary devices are generally contraindicated because of the skeletal immaturity of these patients, and external fixation is associated with a high complication rate. As a result, flexible nailing is being utilized with increasing frequency. It is essential for the clinician to understand the pearls and pitfalls associated with the utilization of these flexible nails; particularly in regards to their immediate use in the context of open fractures and the risk of compartment syndrome postoperatively after fixation.

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Section: Discussionmentioning

confidence: 99%

Section: Flexible Nail Fixationmentioning

confidence: 99%

Section: Initial Assessmentmentioning

confidence: 99%

Section: Initial Assessmentmentioning

confidence: 99%

See 2 more Smart Citations

Flexible Intramedullary Nailing of Unstable and/or Open Tibia Shaft Fractures in the Pediatric Population

Pandya

2016

Journal of Pediatric Orthopaedics

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“…Für offene Frakturen wird in der Regel der Fixateur externe empfohlen, es ist aber durchaus auch eine Stabilisierung mit ESIN möglich [9], Platten werden nicht empfohlen.…”

Section: Unterschenkelunclassified