The management of paediatric diaphyseal femoral fractures: a modern approach

Khoriati, Al-Achraf; Jones, Carl; Gelfer, Yael; Trompeter, Alex

doi:10.1007/s11751-016-0258-2

Cited by 35 publications

(53 citation statements)

References 63 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Conservative treatments have many advantages being less invasive and practically without risk of soft tissues or growth plate injuries that are described in surgical procedures. On the other hand, conservative treatments present some important limitations: Prolonged skin traction with long hospitalization, significant patient discomfort, difficulties with hygienic care, and long weight-bearing restrictions[ 12 ]. Moreover, casting needs to be done in the operation theatre under general anaesthesia with similar time of surgical procedures, and similar radiation exposure for closed reductions in which sometimes it is necessary to use a specific invasive device[ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Titanium elastic nailing in diaphyseal femoral fractures of children below six years of age

Donati

Mazzitelli

Lillo

et al. 2017

WJO

View full text Add to dashboard Cite

AIMTo report the clinical and radiographic results of titanium elastic nail (TEN) in diaphyseal femoral fractures of children below age of six years.METHODSA retrospective analysis of 27 diaphyseal femoral fractures in children younger than six years treated with TEN between 2005 and 2015 was conducted. Patients were immobilized in a cast for 5 wk and the nails were removed from 6 to 12 wk after surgery. Twenty-four cases were clinically and radiographically re-evaluated using the Flynn’s scoring criteria, focusing on: Limb length discrepancy, rotational deformity, angulation, hip and knee range of motion (ROM), functional status, complications, and parent’s satisfaction.RESULTSSixteen males and eight females with a mean age of 3.2 years at the time of treatment were re-evaluated at an average follow-up of 58.9 mo. No cases of delayed union were observed. The mean limb lengthening was 0.3 cm. Four cases experienced limb lengthening greater than 1 cm and always minor than 2 cm. Twelve point five percent of the cases showed an angulation < 10°. Complete functional recovery (hip and knee ROM, ability to run and jump on the operated limb) occurred in 95.7% of cases. Complications included two cases of superficial infection of the TEN entry point, one case of refracture following a new trauma, and one TEN mobilization. According to the Flynn’s scoring criteria, excellent results were obtained in 79.2% of patients and satisfactory results in the remaining 20.8%, with an average parent’s satisfaction level of 9.1/10.CONCLUSIONTEN is as a safe, mini-invasive and surgeon-friendly technique and, considering specific inclusion criteria, it represents a useful and efficacy option for the treatment of diaphyseal femoral fractures even in patients younger than six years of age.

show abstract

Section: Discussionmentioning

confidence: 99%

Titanium elastic nailing in diaphyseal femoral fractures of children below six years of age

Donati

Mazzitelli

Lillo

et al. 2017

WJO

View full text Add to dashboard Cite

show abstract

“…Today, the trends have veered towards operative fixation due to the benefits of early mobilization and shorter hospital stays. 5,6 Ideally, fixation of paediatric diaphyseal fractures should be able to produce an internal splint that maintains reduction till callus is formed, shares loads and does not endanger the physis or vascularity. Several studies have shown that titanium elastic nailing system/ flexible intramedullary nailing fixation meets these requirements.…”

Section: B a C K G R O U N Dmentioning

confidence: 99%

Outcome of Surgically Managed Diaphyseal Fractures in Children- A Prospective Study

Reddy¹,

Dhaniwala²

2020

jemds

View full text Add to dashboard Cite

BACKGROUND Childhood injuries have become a global public health concern. It is estimated that 10-25 % of paediatric injuries are fractures. The definitive treatment of paediatric diaphyseal fractures has always remained controversial and determined by surgical experience and local trends of practice. The aim of this study was to study the outcome of surgically managed diaphyseal fractures in children. METHODS A prospective interventional study was done comprising of 42 fractures in 28 children having displaced diaphyseal fractures of major long bones. Flynn's scoring criteria was used to study the outcome. RESULTS The observations of this study are based on 42 surgically managed diaphyseal fractures in long bones in 28 children. The mean age of patients was 10.85 years. The commonest mode of injury was fall while playing (from level ground) (18 cases, 4.29%). The commonest bones to get fractured were both radius and ulna together (50%), followed by femur (25%), tibia (21.43%) and ulna singly (3.57%). The commonest location of fracture was middle third shaft (25 fractures, 59.52%). Transverse fractures accounted for major proportion of this series. Among the 42 fractures, 39 fractures were treated with titanium elastic nailing and 2 compound fractures were treated with debridement and external fixator application. One 15 year old girl was treated by femur interlock nailing. Among the 25 children who could be followed up, the average follow up period was 22.08 weeks. The mean period of union was 10.69 weeks. Majority of the fractures had excellent outcome (30 fractures, 76.92%), 7 fractures (17.95%) had satisfactory outcome while only 2 fractures (5.13%) had poor outcome. CONCLUSIONS Titanium elastic nailing (TENS) is found to be an effective method of treating closed displaced diaphyseal fractures in children. It is better than plaster cast immobilization due to shorter period required for union, better fracture reduction and stabilization besides prevention of stiffness of adjacent joints and fracture disease. More use of this method is recommended due to these advantages.

show abstract

“…It should be considered that the anatomical segment being examined has peculiar characteristics, which may affect management of the patient. These characteristics include choice if fixation device, surgical timing, patient age, associated lesions, polytrauma (DCO vs ETC treatment), relative frequency of malunions, and atypical fractures [7][8][9][10][11][12] . While it may be invasive and occasionally generate complications such as infections, device, breakage and consolidation alterations, osteosynthesis has numerous advantages, such as early mobilization, a greater stability at the fracture site, and a limited stay in hospital.…”

Section: Treatment Typementioning

confidence: 99%

“…The anterograde insertion point starts with a longitudinal incision proximal to the apex of the greater trochanter that provides for three introduction points of the nailing implant according to the design of the device and the morphological characteris- tics of the patient. They are pyriform fossa, apex of the greater trochanter or laterally to the apex of the greater trochanter checked via fluoroscopic control 6,10,15 . Retrograde access starts with an incision at the level of the patellar tendon to identify the entry point located at the top of the intercondylar fossa through fluoroscopic control in 2 orthogonal views (A-P and L-L) 6,17 .…”

Section: Treatment Typementioning

confidence: 99%

Appropriateness of devices in the surgical treatment of femoral shaft fractures

Biserni

Talesa

2020

Lo Scalpello

View full text Add to dashboard Cite

Femoral shaft fractures occur mainly due to high-energy traumas. To date, osteosynthesis represents the gold standard for the treatment of such fractures, and may be undertaken with a variety of stabilization methods: endomedullary nailing, plating, external fixation. However, there is no EBM literature unequivocally addressing a treatment for this topic. In order to appropriately treat femoral shaft fractures the authors believe it is essential to consider the pattern of lesion from an anatomo-pathological viewpoint, to evaluate the fracture pattern and put in relation to the patient's conditions, pointing out that surgical versatility, trauma experience and skills and the appropriateness in choosing the devices of synthesis is essential to approach such lesions.

show abstract

The management of paediatric diaphyseal femoral fractures: a modern approach

Cited by 35 publications

References 63 publications

Titanium elastic nailing in diaphyseal femoral fractures of children below six years of age

Titanium elastic nailing in diaphyseal femoral fractures of children below six years of age

Outcome of Surgically Managed Diaphyseal Fractures in Children- A Prospective Study

Appropriateness of devices in the surgical treatment of femoral shaft fractures

Contact Info

Product

Resources

About