Elastic Stable Intramedullary Nailing of Femoral Shaft Fracture-Experience in 48 Children

Authors

Jimmy Mellepuram V.M.M.C.Karaikal, Pondicherry, India

Rajesh Govindasamy V.M.M.C.Karaikal, Pondicherry, India

Ramkumar Gnanasundaram Saveetha Medical College, Chennai, India

Saravanan kasirajan V.M.M.C.Karaikal, Pondicherry, India

Syed Ibrahim V.M.M.C.Karaikal, Pondicherry, India

Abstract:

Background: Femoral shaft fractures are an incapacitating pediatric injury accounting for 1.6% of all pediatric bonyinjuries. Management of these fractures is largely directed by age, fracture pattern, associated injuries, built of the childand socioeconomic status of the family. We retrospectively evaluated the use of elastic stable intramedullary nail (ESIN)in surgical management of femoral shaft fractures in children and its complications.Methods: Fifty two children were treated with titanium elastic nails (TEN) from June 2009 to June 2014 at ourinstitution. At the end of the study there were 48 children. Fractures were classified according to Winquest andHansen’s as Grade I (n=32), Grade II (n=10), Grade III (n=6) and compound fractures by Gustilo and Anderson’sclassification, Grade I (n=5), Grade II (n=3 ). There were 36 mid-shaft fractures, 7 proximal third shaft fractures, 5distal third shaft fractures. The final results were clinically evaluated by using Flynn’s criteria and radiologically byAnthony et al’s criteria.Results: The mean duration of follow-up was 20 months (range 12 – 40 months). All fractures healed radiologicallywith grade III callus formation at 9 – 12 weeks (mean 9.7 weeks). The results were analyzed using Flynn’s criteriaand were excellent in 40 children (83%) and satisfactory in 8 children (17%). The soft tissue discomfort near the kneeproduced by nail ends was the most common problem in our study (25%). Other complications include limb shortening(n=5), Varus malunion (n=4), Nail protruding site infection (n=4) and nail migration (n=2). There was no delayed union,non-union or refractures.Conclusion: TEN is minimally invasive, safe, relatively easy to use and an effective treatment for fracture shaft offemur in properly selected children.

Upgrade to premium to download articles

Already have an account?login

similar resources

Elastic stable intramedullary nailing of femoral shaft fractures in children.

We report the use of elastic stable intramedullary nailing (ESIN) in 123 fractures of the femoral shaft in children. Flexible rods are introduced through the distal metaphyseal area, and the aim is to develop bridging callus. Early weight-bearing is possible and is recommended. There was one case of bone infection and no delayed union. Complications were minimal, the most common being minor ski...

full text

Open adult femoral shaft fracture treated by early intramedullary nailing.

In two hospitals, 115 consecutive open femoral shaft fractures were treated by meticulous wound excision and early locked (97) or unlocked (18) intramedullary nailing. All the fractures united; union was delayed in four, three of which required bone grafting. The average range of knee flexion at follow-up was 134 degrees (60 to 148). Five patients had a final range of less than 120 degrees, but...

full text

bed-assisted closed reduction intramedullary nailing for femoral shaft fracture

Objective: To compare treatment of femoral shaft fractures using traction bed assisted closed reduction (CR) or conventional open reduction (OR) for intramedullary nail fixation. Methods: The study group consisted of 126 patients with femoral shaft fractures who were treated via intramedullary nail fixation from July 2009 to May 2013. Traction bed assisted CR was adopted in 71 patients, while O...

full text

[Intramedullary nailing in femoral shaft fractures].

full text

Locked intramedullary nailing of femoral shaft fractures.

One hundred twenty-three femoral shaft fractures were treated with Grosse-Kempf slotted, locked nails and followed for a median 20 (range, 12-60) months. There were eight intraoperative and 11 postoperative complications, among them two superficial and two deep infections. Most of the intraoperative complications and some postoperatively lost reductions could have been prevented by a better ope...

full text

Elastic robust intramedullary nailing for forearm fracture in children

BACKGROUND Forearm fractures are the most common fractures in children (23% of all fractures). Basically there are two treatment options available for diaphyseal forearm fractures in children: closed reduction with cast immobilisation (conservative therapy) and the elastic stable intramedullary nailing (ESIN). Treatment decision is influenced by the doctor's estimation of fracture instability. ...

full text

My Resources

Save resource for easier access later

Save to my library Already added to my library

{@ msg_add @}

Journal title

The Archives of Bone and Joint Surgery

volume 6 issue 1

pages 39- 46

publication date 2018-01-01

unfollow

{@ msg @}

By following a journal you will be notified via email when a new issue of this journal is published.

Keywords

Bone nailing Femur Intramedullary fracture fixation Malunited fracture

Hosted on Doprax cloud platform doprax.com