The clinical features, management options and complications of paediatric femoral fractures

Duffy, Sean; Gelfer, Yael; Trompeter, Alex; Clarke, Anna; Monsell, Fergal

doi:10.1007/s00590-021-02933-1

Cited by 22 publications

(19 citation statements)

References 93 publications

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“…Die Plattenosteosynthese stellt insbesondere zur Versorgung proximaler oder distaler Femurfrakturen eine gute Alternative dar, da sich diese teils schwer durch intramedulläre Verfahren stabilisieren lassen 20 . Im Schaftbereich eignet sich die Plattenosteosynthese vor allem für sehr instabile und mehrfragmentäre Frakturen sowie bei langstreckiger Trümmersituation 21 .…”

Section: Oberschenkelschaftfrakturenunclassified

Kindertraumatologie – untere Extremität. Teil 1

Graner¹,

Schlickewei²,

Oberle³

2022

Orthopädie und Unfallchirurgie up2date

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Femurfrakturen im Wachstumsalter sind seltene Verletzungen, die in der Regel auf schwere Traumata zurückzuführen sind. Oberschenkelschaftfrakturen werden heute – außer bei Kindern bis zu 3 Jahren, wo die Therapie konservativ erfolgt – mittels elastischer Marknagelung (ESIN) als Therapie der Wahl behandelt. Auch Meniskus- und Kreuzbandverletzungen werden inzwischen operativ versorgt.

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Section: Oberschenkelschaftfrakturenunclassified

Kindertraumatologie – untere Extremität. Teil 1

Graner¹,

Schlickewei²,

Oberle³

2022

Orthopädie und Unfallchirurgie up2date

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“…Distal femur growth disorder is the most common complication ( 7 ); growth arrest is a frequent occurrence of fractures in this region, resulting in axial and length-related deformities. Long-term surveillance is recommended to identify evolutionary deformity and provide an opportunity of early intervention ( 9 ). Adams et al found that physeal arrest is the most common consequence following this type of injury, and when it is associated with growth disturbances such as axial and length-related deformity, it should require surgical intervention in up to 60% of cases ( 8 ).…”

Section: Discussionmentioning

confidence: 99%

Bone wax in the treatment of partial epiphysiodesis of distal femoral growth plate: Case report at 10-year follow-up

Basiglini

Aulisa²,

Bandinelli³

et al. 2022

Front. Surg.

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The growth plate is the weakest structure in the skeleton of a child and a frequent site of injury or fracture; physeal injuries represent 15%–30% of all fractures in children. Of all growth plate fractures, the incidence of growth arrest and disorders is around 15%. Here, we discuss a female patient who, at the age of 5 years, was treated for a polytrauma that involved a complex lesion of the growth plates of the knee. Four days after trauma, she underwent closed reduction surgery and internal fixation with cannulated screws for femoral and tibial fractures of the growth plate. A 20° valgus deviation of the left knee was found at 3-month postoperative clinical check-up likely as a result of a growth disorder of the femur. She was diagnosed with valgus knee secondary to epiphysiodesis of the lateral portion of the femoral physis and she was readmitted to the hospital. In the operating theater, an open femoral de-epiphysiodesis was performed with a burr; the drilled hole was then filled with bone wax. At 20-month post-trauma follow-up, the left knee was still valgus about 20° relative to the other side. During follow-up, a slow but progressive improvement in the axis of the lower limbs was noted. Clinical and radiographic control 10 years after the trauma showed a complete recovery of the axis of the lower limbs. In the initial stages, the presence of bone wax in the area of de-epiphysiodesis allowed for stabilization of the deformity on the 20° of preoperative valgus. The interpretation of the growth cartilage activity occurred in an asymmetrical way such as to realign the femoral load axis, it can be based on the different mechanical stimulus on the two knee areas due to the preexisting deformity. There is no unanimous evidence in the literature in terms of management of growth disorders resulting from this type of injury. Bone wax resulted in effectively filling the hole of de-epiphysiodesis in the distal femoral growth plate and allowed us to obtain the response of the growth plate and to improve the recovery time in young children.

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“…Children between the ages of 5 and 15 who suffer a femur fracture are increasingly opting for surgical intervention. Plates, external fixators, hard locking nails, and flexible intramedullary nails are all used in surgical procedures for children and adolescents (8) .…”

Section: Discussionmentioning

confidence: 99%

Elastic Stable Intramedullary Nailing Functional and Clinical Outcomes among Femoral Fractures in Pediatrics Aged 4-11 Years

Sebaei¹,

Abdelrahman²,

Ali³

et al. 2022

The Egyptian Journal of Hospital Medicine

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Background: In children, femoral shaft fractures are often treated using elastic stable intramedullary nailing (ESIN). Objective: To evaluate the functional as well as clinical outcomes of ESIN for femoral fractures in children aged 4-11 years. Patients and Methods: At Orthopedic Surgery Department of Zagazig General Hospital 18 cases diagnosed as pediatric femoral fractures were stabilized using flexible intramedullary nailing. Results: Skin irritation due to nail endings was the most prevalent consequence and was seen in 7 patients. Other complications were superficial infection (n=2), limb length inequility (n=2) and varus angulation (n=1). At 3 months follow-up, all patients had complete range of motion in their hips and knees; three patients (27.77%) had slight restriction in knee flexion, but this was recovered by 6 months follow-up. Excellent Flynn elastic nail scoring results were demonstrated in 72.22%, satisfactory results in 27.77% and none of the patients showed poor results. Conclusion: Flexible Intramedullary Nailing resulted in the best possible functional and radiological outcomes for patients with femoral shaft fractures and is a safe treatment option.

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The clinical features, management options and complications of paediatric femoral fractures

Cited by 22 publications

References 93 publications

Kindertraumatologie – untere Extremität. Teil 1

Kindertraumatologie – untere Extremität. Teil 1

Bone wax in the treatment of partial epiphysiodesis of distal femoral growth plate: Case report at 10-year follow-up

Elastic Stable Intramedullary Nailing Functional and Clinical Outcomes among Femoral Fractures in Pediatrics Aged 4-11 Years

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