Use of flexible intramedullary nailing in treating diaphyseal fractures of long bone of lower limb in children

Ghilley, Sanjay Kumar; Meena, Manoj; Jhanwar, Purushottam; Jain, Harish Kumar

doi:10.4103/jotr.jotr_5_19

Cited by 4 publications

(11 citation statements)

References 16 publications

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“…In the present study, there were 17 boys (60.71%) and 11 girls (39.29%). Similar preponderance of males was found in studies conducted by Ghilley SK et al 13 (64% boys and 36% girls), Baig MS et al 10 (73.3% boys and 26.7% girls), Tandon T et al 14 (54.8% boys and 45.2% girls), Babu A et al 15 (78.6 % were males and 21.3 % were females) and Arora R et al 12 (67% males, 33% females). Male preponderance in all these studies can be attributed to higher level of activity among male children as compared to female children.…”

Section: Discussionsupporting

confidence: 89%

“…The most common fracture pattern was transverse (76.19%), followed by oblique (14.29%). Gilley SK et al 13 too found transverse fractures (44%) to be the most common in his study, followed by oblique fractures.…”

Section: Discussionmentioning

confidence: 69%

“…Flynn JM et al 7 noted limb length discrepancy in 6 cases (10.3%). In the study by Ghilley SK et al 13 22% of cases showed limb length discrepancy. Ligier JN et al 9 found 4 cases of lengthening more than 1 cm and 3 cases of shortening more than 1 cm.…”

Section: Discussionmentioning

confidence: 90%

“…Malalignment up to 5 degrees was observed in 5 cases (12.82%). In the study done by JM Flynn et al 7 , there were 6 (10.3%) cases of angular deformity >5 degrees while Ghilley SK et al 13 found 3 cases (9.35%) of angular deformity >5 degrees. To avoid any residual angulation, it is important that the nails are introduced at the same level and have identical curvatures.…”

Section: Discussionmentioning

confidence: 93%

“…In the study by Vaish A et al 20 they obtained excellent outcome in 73%, satisfactory outcome in 27% cases, based on Flynn's scoring criteria. Ghilley SK et al 13 found 80% cases had excellent outcome while 20 % had satisfactory outcome. Kumar P et al 22 found 75% excellent, 15.6% satisfactory and 9.4% poor outcome.…”

Section: Discussionmentioning

confidence: 95%

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

Reddy¹,

Dhaniwala²

2020

jemds

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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.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 95%

See 3 more Smart Citations

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

Reddy¹,

Dhaniwala²

2020

jemds

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Functional Outcome of Titanium Elastic Nailing in Pediatric Tibial Fracture

2022

PJMD

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Background: Tibial Diaphyseal fracture (TDF) is the third most common fracture seen in the pediatric population. Titanium elastic nailing (TEN) has been ideal for the management of tibial diaphyseal fractures to prevent complications. Therefore, this study aimed to access the functional outcome of TEN in pediatric Tibial diaphyseal fracture. Methods: This prospective cohort study was conducted on n=87 skeletally immature patients (6-12 years) at the two hospitals in Karachi from 1st November 2019-30th April 2021 including patients having unilateral, closed Tibial Diaphyseal fracture. The 75 patients (12 of them were lost follow-up) were analyzed in terms of wound infection, union, weight-bearing, limb shortening, rotation, angulation, and range of movement at knee and ankle joints. Paired t-test was used to compare the variables with a p-value < 0.05 was considered statistically significant. Results: Patients n=75 in this study had a mean age of 8.32±1.92 years with a mean weight of 25.8±6.9. The most frequent cause of injury was traffic accident 49(65.3%), followed by falling 19(25.3%) and 7(9.4%) with other causes. The most common fracture type was transverse 45(60%), followed by oblique 26(34.7%), and the remaining 4(5.3%) had a spiral fracture. All patients were allowed full weight-bearing at 9.8 ±1.5 week. At the end of this study, all patients regained knee and ankle range of motion (p< 0.0001). Conclusion: Titanium elastic nailing was the ideal procedure for Tibial Diaphyseal fracture in the pediatric population, resulting in a short hospital stay, a rapid rehabilitation without complications. Keywords: Pediatrics; Pediatric Tibial Diaphyseal Fracture; Titanium; Titanium Elastic Nailing; Functional Outcome; Movement.

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Early Outcomes of Flexible Intramedullary Nailing in Pediatric Shaft of Femur Fractures

Hashmi

Ahsan

Chughtai

et al. 2021

PAFMJ

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Objective: To study the early outcomes and complications of fixation of pediatric shaft of femur fractures using flexible intramedullary nail. Study Design: Prospective observational study. Place and Duration of Study: Orthopedic Department, Bahawal Victoria Hospital Bahawalpur, from Jan to Jun 2021. Methodology: Children between the ages of 5-11 years with shaft of femur fractures were included in the study. Fixation of fracture was done using elastic intramedullary nail. Final outcomes of fixation were observed using Flynn and Schwend Scoring System. Six-month follow-up was done in all cases. Data was analyzed using SPSS-20. Results: Total 70 cases having shaft of femur fracture were included in the study. Age range of cases was 5-11 years with mean age of 7.75 ± 1.66 years and mean weight of 24.44 ± 4.77 kilograms. Mean diameter of femur medullary canal was 7.48 ± 0.63 millimeters and mean diameter of flexible nail was 3.03 ± 0.26 millimeters. Mean post-operative period of radiological union of fracture was 8.57 ± 1.05 weeks. Per-operatively, fracture site was approached in 4 (5.7%) cases. Migration of nail was not seen in any case. Final outcomes according to Flynn and Shwend Score were excellent in 62 (88.5%), satisfactory in 7 (10%) and poor in 1 (1.4%) case. Conclusion: Fixation of shaft of femur fracture using flexible intramedullary nailing technique is safe and reliable with good outcomes among children between 5-11 years of age.

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Use of flexible intramedullary nailing in treating diaphyseal fractures of long bone of lower limb in children

Cited by 4 publications

References 16 publications

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

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

Functional Outcome of Titanium Elastic Nailing in Pediatric Tibial Fracture

Early Outcomes of Flexible Intramedullary Nailing in Pediatric Shaft of Femur Fractures

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