Pediatric Femoral Shaft Fractures Treated With Titanium Elastic Nailing

Sun, Liao Jun; Yang, Jie; Tian, Nai F.; Wu, Yao; Xin, Yu; Hu, Wei; Guo, Xiao Shan; Chen, Hua

doi:10.3928/01477447-20141023-60

Cited by 7 publications

(4 citation statements)

References 20 publications

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“…Uçar 21 reported on 43 ESINs of femoral shaft fractures in children with a mean operative time of 71 minutes and a mean fluoroscopy time of 80 seconds. With a similar technique in femur, Sun et al 22 found an operative time of 53 minutes (sd 15) and an intraoperative fluoroscopy time of 65 seconds (sd 29).…”

Section: Discussionmentioning

confidence: 99%

Irradiation level related to intraoperative imaging device in paediatric elastic stable intramedullary nailing: Preliminary prospective study on 51 patients using PCXMC software

Prod’homme

Docquier²,

Miri³

et al. 2020

Journal of Children's Orthopaedics

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Purpose Radiation-induced cancers due to imaging devices concern above all the growing child, however, to date, intraoperative irradiation doses are not well-documented in children. The goal of the study was to evaluate the intraoperative doses received by patients operated with the use of a C-arm in traumatology, as well as the lifetime attributable risk of cancer death (LAR) related to the irradiation of the imaging device. Methods From 1 April 2017 to 31 March 2019, we started a multicentre study and prospectively recruited all consecutive children who needed elastic stable intramedullary nailing (ESIN) for long-bone fracture. We collected demographic and operative data, with dose reports including duration and doses. The main outcome was the effective dose (ED) in millisievert (mSv), calculated with PCXMC software, and the secondary outcome was the LAR expressed as a percentage. Results In all, 51 patients operated on using 2D C-arm imaging were included in this study. The mean ED was 0.085 mSv (sd 0.10; 0.002 to 0.649). Overall LAR was 6.5 x 10−4% (sd 6.7 x 10−4%; 0.1 x 10−4% to 28.3x10−4%). Univariate linear regression showed a significant association between ED and irradiation time (p < 0.001). There was no significant association between ED and other outcomes (p > 0.05). Conclusion Treatment of long-bone fractures by ESIN found a low level of effective doses with utilization of the C-arm device in current practice. Further studies on a larger sample are needed to confirm these results. Level of Evidence II

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Section: Discussionmentioning

confidence: 99%

Irradiation level related to intraoperative imaging device in paediatric elastic stable intramedullary nailing: Preliminary prospective study on 51 patients using PCXMC software

Prod’homme

Docquier²,

Miri³

et al. 2020

Journal of Children's Orthopaedics

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“…Children at school age are treated using various methods, such as compression plating, submuscular plating, locking bridge plates, and rigid intramedullary nails. Stainless steel or titanium elastic nails and external fixators were used (11) .…”

Section: Discussionmentioning

confidence: 99%

Role of Elastic Stable Intramedullary Nailing in Diaphyseal Fractures in Children

Hassan¹,

Sebai²,

Salama³

et al. 2021

The Egyptian Journal of Hospital Medicine

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Background: All femoral or tibial fractures regardless of associated injuries, intramedullary nailing (IMN) has its more advantages in rapid rehabilitation, good effects on the child and his family and strong fixation. Objective: To assess the role of elastic stable IMN in union of diaphyseal fractures of long bones in children. Patients and Methods: A prospective and retrospective analytical study on ten children with isolated femoral or tibial fractures who were admitted to Orthopedic Department, Zagazig University Hospitals. They were divided equally into group I that included 5 patients with femoral shaft fracture managed with IMN and group II, which included 5 patients with tibial shaft fracture managed with IMN. Their mean age was 4.7 years old. Results: When the groups compared, the spica cast group was found to have a shorter duration of hospital stay compared to elastic nail group. The knee range of motion of the spica cast group was found to be better compared to the elastic nailing group. The elastic nailing group was found to have started walking earlier both with and without support. Patients with intramedullary nailing started to walk with aid after one month and independently after 2 weeks. Patients with spica cast started to walk with aid after 2 months and independently after 12 weeks. Conclusion: None of the available treatment tools to fix diaphyseal long bones fractures in preschool children is perfect because each method has its own set of complications. However, constitute the motive for developing new techniques or changing the design of currently available devices.

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“…The most widely used method is closed reposition with intramedullary osteosynthesis under roentgen diascopy during general anesthesia. Operative methods include external fixation ( 18 , 19 ), plates ( 20 ), screws ( 21 ), flexible ( 22 ) or rigid intramedullary osteosynthesis, and Kirschner wires ( 23 , 24 ). Each of them has its own advantages, but also disadvantages ( 25 - 28 ).…”

Section: Introductionmentioning

confidence: 99%

Treatment of Pediatric Femoral Fractures in the City of Zagreb

Antabak

Boršćak

Čagalj

et al. 2020

ACC

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Femur fractures in children can be treated with a number of operative and conservative methods. Numerous factors determine which method is optimal for a specific fracture. The aim of this research was to analyze distribution of femur fractures in children living in the urban communities of Zagreb and Zagreb County by localization, type and frequency of treatment methods used according to age and fracture mechanism. The research included 103 children aged up to 18 years, treated for femur fractures at the Zagreb University Hospital Centre and Zagreb Children's Hospital. Data were collected from these institutions and a retrospective study covered the 2010-2015 period. The cause of fracture and diagnosis were coded with the help of the International Statistical Classification of Diseases and Related Health Problems. Operative treatment was applied in 55% of cases, which is contrary to previous researches. The highest incidence of femur fractures was recorded in the 0-to 4-year age groups, accounting for 49.1% of all fractures. These fractures mostly occurred due to falls and were more often treated with non-operative methods. All other age groups were mostly treated with operative methods. Coxofemoral immobilization and traction were used as non-operative methods, whereas flexible intramedullary nailing was the most frequently used operative method. The treatment depended on age, complexity of the fracture, fracture type, fragment displacement, and associated injuries. The cause was also an important factor on choosing the treatment method. Nonoperative treatment was mostly used for fractures caused by falls (64.71% of cases due to falls) and operative treatment was mostly used for fractures caused by traffic accidents (79.4% of cases due to traffic accidents). It is a wide-known opinion that the best treatment for femur fractures in children is non-operative treatment. However, recent studies have shown that the use of operative methods in femur fracture treatment is growing. Our cohort of children treated during a five-year period (2010)(2011)(2012)(2013)(2014)(2015) also underwent operative treatment more often than non-operative one. Two non-operative and eight operative methods were used. With such a large number of methods, it is clear that there is no unique method for all fractures. However, it is clear that the trend of using operative treatment is connected to the perennial trend of considerable sociodemographic and socioeconomic changes in urban settings such as Zagreb. Lifestyle changes directly affect the prevalence of femur fractures among children, as well as approach to treatment choice. General opinion is that most of fractures that occur at an early age can be treated with non-operative methods. Our research on femur fractures in children confirmed this rule. The youngest age group that had the highest incidence of fractures (49.1% of all fractures) was treated with non-operative methods in 75% of cases. Operative methods prevailed in other age groups. Similar results have been published by other ...

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Pediatric Femoral Shaft Fractures Treated With Titanium Elastic Nailing

Cited by 7 publications

References 20 publications

Irradiation level related to intraoperative imaging device in paediatric elastic stable intramedullary nailing: Preliminary prospective study on 51 patients using PCXMC software

Irradiation level related to intraoperative imaging device in paediatric elastic stable intramedullary nailing: Preliminary prospective study on 51 patients using PCXMC software

Role of Elastic Stable Intramedullary Nailing in Diaphyseal Fractures in Children

Treatment of Pediatric Femoral Fractures in the City of Zagreb

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