Low complication rate of elastic stable intramedullary nailing (ESIN) of pediatric forearm fractures

Kruppa, Christiane; Bunge, Pamela; Schildhauer, Thomas A.; Dudda, Marcel

doi:10.1097/md.0000000000006669

Cited by 51 publications

(52 citation statements)

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“…Most series showed good to excellent results using this method (13)(14)(15). The rate of complications associated with TENs has been reported to be 15-67% in the literature (16,17). Flynn and Waters (18) reported a complication rate of 14.6%, however, Shah et al (19) reported that the complication rate was 0%.…”

Section: Discussionmentioning

confidence: 80%

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Elastic Stable Intramedullary Nailing for Pediatric Forearm Fractures: A Retrospective Analysis of Thirty Four Cases

Çapkın¹,

Aydın²,

Günaydın³

et al. 2018

Haseki

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Aim:The purpose of this investigation was to present our institutional experience of 34 pediatric both bone forearm fractures treated with titanium elastic intramedullary nails. Methods:Thirty-four patients, who were treated with titanium elastic nail for both bone forearm fractures diagnosis between 2011 and 2016, were included in the study. Clinical and radiological evaluation of the patients was retrospectively analyzed.Results: Bone healing process was completed for all patients at a mean of 6.6 weeks. The implants were removed at a mean time of 9.7 months from the index operation. Complications, including skin infections at the entry side of the nail, were recorded in three (8.82%) patients. These three patients had type 1 open fracture according to the Gustilo-Anderson classification and were treated with first generation cephalosporins. In a subjective measure of outcome during follow-up, it was observed that 33 patients (97.06%) were very satisfied and one (2.94%) was satisfied; no patient reported being not satisfied. Conclusion:Since titanium elastic nailing is a safe and effective method of treatment with advantages of easy implantation and removal as well as excellent cosmetic and functional results, elastic stable intramedullary nailing is the first treatment option that should be considered in pediatric both bone forearm fractures.

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Section: Discussionmentioning

confidence: 80%

“…In their study, Antabak et al (20) found a complication rate of 25% among 88 patients. Kruppa et al (17) reported a complication rate of 8.9%, 6.9% of which underwent reoperation. In our study, complications including infections at the entry side of the nail were recorded in three (8.82%) patients.…”

Section: Discussionmentioning

confidence: 99%

Elastic Stable Intramedullary Nailing for Pediatric Forearm Fractures: A Retrospective Analysis of Thirty Four Cases

Çapkın¹,

Aydın²,

Günaydın³

et al. 2018

Haseki

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“…As a major complication, refractures are frequently seen, even with ESIN in situ. 29 Higher re fracture rates can be attributed to early implant removal and improper physiotherapy.…”

Section: Resultsmentioning

confidence: 99%

Functional outcome of diaphyseal fractures of forearm in adolescents treated with TENS

et al. 2019

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Background: A retrospective case series study was done on forearm diaphyseal fracture in adolescents treated with TENS (titanium elastic nailing system). Purpose of the study was analysis of functional outcome of TENS in forearm diaphyseal fractures in children between 12-18 year age group.Methods: We retrospectively evaluated 30 patients operated by same senior surgeon during the period from March 2014 to February 2015 with closed diaphyseal forearm fractures in age group 12–18 years treated with TENS in whom closed reduction could not be achieved. Nail diameter taken as 33-40% of narrowest diameter of diaphysys were introduced proximally in ulna and distally in radius under image intensifier in closed manner. Postoperatively, patients encouraged for active shoulder, elbow and finger movements and suture removal done after 2 weeks. Patients were followed up for minimum period of one year. Results: In terms of union and range of motion using Anderson et al criteria 24 patients had excellent results, 4 patients had satisfactory results and one patient had poor result having non-union of ulna. Two patients had superficial infection at the nail entry site which eventually resolved. One patient lost for follow up.Conclusions: We conclude that TENS in both bone forearm fractures in adolescent age group in terms of union and range of motion is a minimally invasive and effective method of fixation.

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“…The work of these authors shows that flexible intramedullary fixation is now the basic form of treating pediatric forearm fractures [12]. Based on a retrospective assessment of 174 children with forearm bone fractures, Kutsikovich et al, they selected the most likely prognostic factors for the secondary instability of bone fragments after an operative treatment.…”

Section: Discussionmentioning

confidence: 99%

Comparison of complications of the treatment of diaphyseal forearm fractures in children with respect to the treatment method

Wilczyński¹,

Ciszewski²,

Matuszewski³

2020

Chir. Narzadow Ruchu Ortop. Pol.

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Introduction. Forearm fractures are the second most common injuries to the locomotor system in children, after injuries to the distal forearm. Usually, pediatric forearm fractures occur due to indirect violence. In the treatment of forearm fractures in children, we aim to achieve union, correct length and axis of both forearm bones. Forearm fractures can be treated non-operatively, with casting, as well as operatively. In children, the most commonly used operative method is closed reduction and intramedullary stabilization using TENs. We cannot forget about complications during treatment. Aim. The aim of the study is to analyze the most common late complications of diaphyseal fractures of both forearm bones in children in relation to the treatment method. Material and methods. The study included 120 children aged 3-17 y.o., hospitalized in the Pediatric Orthopedics and Rehabilitation Clinic at the Medical University in Lublin in 2014-2018. The children were divided into 2 groups based on the type of diaphyseal forearm fractures. The analysis included the type and frequency of complications with regard to the treatment method. Results. The study groups consisted of 57 patients treated non-operatively-with casting and 63 patients treated operatively with flexible intramedullary nails. 24 girls and 33 boys were treated non-operatively. 13 girls and 50 boys were treated operatively. Among 61 patients treated non-operatively, 45 had no complications, 14 developed refractures, 1 had a delayed union, and 1 patient had a non-union. Among 59 patients treated operatively, 53 had no complications, 5 developed refractures, and 1 had a delayed union. The most common complication in both modalities was refracture. The complications of non-operative treatment were managed non-operatively in 10 patients and operatively in 4 patients. Operative treatment complications in 1 patient were managed non-operatively while 6 required repeat intramedullary fixation. Any form of treatment complications developed in every fourth patient who received non-operative treatment, while in the case of flexible intramedullary fixation, in every tenth patient. Conclusions. The method of management did not significantly influence the frequency of a specific complication. These complications were 2.5 times more frequent in non-operative treatment, compared to the operative method.

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Low complication rate of elastic stable intramedullary nailing (ESIN) of pediatric forearm fractures

Abstract: Supplemental Digital Content is available in the text

Cited by 51 publications

References 45 publications

Elastic Stable Intramedullary Nailing for Pediatric Forearm Fractures: A Retrospective Analysis of Thirty Four Cases

Elastic Stable Intramedullary Nailing for Pediatric Forearm Fractures: A Retrospective Analysis of Thirty Four Cases

Functional outcome of diaphyseal fractures of forearm in adolescents treated with TENS

Comparison of complications of the treatment of diaphyseal forearm fractures in children with respect to the treatment method

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