Outcome of Elastic Intramedullary Nailing for the Treatment of Paediatric Femoral Shaft Fractures.

Authors

  • Naseer Ahmed Ch Department of Orthopedic Surgery Sheikh Zayed Medical College/Hospital, Rahim Yar Khan
  • Muhammad Azeem Department of Orthopedic Surgery Sheikh Zayed Medical College/Hospital, Rahim Yar Khan
  • Muhammad Shahnawaz Ahmed Department of Orthopedic Surgery Sheikh Zayed Medical College/Hospital, Rahim Yar Khan
  • Mohsin Bilal Department of Orthopedic Surgery Sheikh Zayed Medical College/Hospital, Rahim Yar Khan

Keywords:

femoral shaft fractures in children, intramedullary elastic nailing, and union rate.

Abstract

Objective: To demonstrate the rate of union after closed elastic intramedullary nail fixation of paediatric femoral shaft fractures.

Methods: The design of our study was descriptive and was conducted from 15-04-2016 to 15-10-2016 at Sheikh Zayed Medical College/Hospital, Rahim Yar Khan. All patients fulfilling inclusion criteria who underwent femur elastic intramedullary nail insertion in retrograde fashion for the treatment of Paediatric femur fractures were enrolled in the study. Patients were in regularly followed un-till radiological union.

Results: A total of 55 patients including 33 males and 22 females with mean age 6.5±1.65 years and mean weight 19.11±4.46 kg were included. Fracture union was seen in 47 (85.45%) patients. There was almost equal union in both male and females with p value of 0.88. Better union was seen in age group of 5 to 8 years with union in 26 out of 29 patients as compared to age group of 9-12 years(p=0.35) Union was better seen in patients with weight less than 20 kg and duration of fracture 5 days or less with p values of 0.06 and 0.45. Thirty (90.91%) out of 33 patients had union in simple fractures as compared to comminuted in 17 out of 22 with p values of 0.16 as displayed.

Conclusion: Elastic intramedullary nailing results in early union of femur shaft fractures in children with simple fractures who presented early and with body weight of less than 20 kilogram.

References

1. Loder RT, O’Donnell PW, Feinberg JR. Epidemiology and mechanisms of femur fractures in children. J Pediatr Orthop. 2006;26(5):561–566.
2. Hinton RY, Lincoln A, Crockett MM. Fractures of the femoral shaft in chil-dren. Incidence, mechanisms, and sociodemographic risk factors. J Bone Joint Surg Am.1999;81(4):500–509
3. Heideken J, Svensson T, Blomqvist P. Incidence and trends in femur shaft fractures in Swedish children between 1987 and 2005. J Pediatr Orthop.2011;31(5):8.
4. McClain, R.F. Clark, C.R. El-Khoury, G.y. C6-7 Dislocateion in the neurologically intact neonate: A patient report. Spine 1989:14:125-126.
5. Hughes BF, Sponseller PD, Thompson JD. Pediatric femur fractures: Effects of spica cast treatment on family and community. J Pediatr Orthop. 1995;15(4):457–460..
6. Reeves RB, Ballard RI, Hughes JL. Internal fixation versus traction and casting of adolescent femoral shaft fractures. J Pediatr Orthop.1990;10(5):592–595.
7. Aronson J, Tursky EA. External fixation of femur fractures in children. J Pediatr Orthop. 1992;12(2):157–163.
8. Beaty JH, Austin SM, Warner WCl. Interlocking intramedullary nailing of femoral shaft fractures in adolescents: Preliminary results and complications. J Pediatr Orthop. 1994;14(2):178–183.
9. Pate O, Hedequist D, Leong N. Implant removal after sub muscular plating for pediatric femur fractures. J Pediatr Orthop. 2009;29:709-712.
10. Mazda K, Khairouni A, Pennecot GF, et. Closed flexible intramedullary nailing of the femoral shaft fractures in children. J Pediatr Orthop. 1997;6(3):198–202.
11. Hedlund R, Lindgren U. The incidence of femoral shaft fractures in children and adolescents Pediatr Orthop 1986;6:47-50.
12. Kirby RM, Winquist RA, Hansen ST Jr. Femoral shaft fractures in adolescents: A comparison between traction plus cast treatment and closed intramedullary nailing. J Pediatr Orthop. 1981;1(2):193–197.
13. Lohiya R, Bachhal V, Khan U, Kumar D, Vijayvargiya V, Sankhala SS, et al. Flexible intramedullary nailing in paediatric femoral fractures; a report of 73 patients. J Orthop Surg Res. 2011;64(6):01-10.
14. Sela Y, Hershkovich O, Sher-Lurie N, Schindler A, Givon U. Pediatric femoral shaft fractures: treatment strategies according to age - 13 years of experience in one medical center. J Orthop Surg Res. 2013;23(8):08-23.
15. Barry M, Paterson JM. A flexible intramedullary nails for fractures in children. J Bone Joint Surg Br. 2004; 86(7): 947-953.
16. Flynn JM, Hresko T, Reynolds RA. Titanium elastic nails for pediatric femur fractures: A multicenter study of early results with analysis of complications. J Pediatr Orthop. 2001; 21: 4–8.
17. Timmerman LA, Rab GT: Intramedullary nailing of femoral shaft fractures in adolescents. J Orthop Trauma. 1993; 7: 331–337.
18. Kissel EU, Miller ME. Closed Ender nailing of femur fractures in older children. J Trauma. 1989; 29: 1585-1588.
19. Aktekin CN, Ozturk AM, Altay M, Toprak A, Ozkurt B, Tabak AY. Flexible intramedullary nailing of children. Ulus Travma Acil Cerrahi Derg 2007; 13(2): 115-121.
20. Singh R, Sharma SC, Magu NK, Singla A. Titanium elastic nailing in pediatric femoral diaphyseal fractures. Indian J Orthop. 2006; 40(1): 29-34.
21. Houshian S, Gothgen CB, Pedersen NW. Femoral shaft fractures in children: elastic stable intramedullary nailing in 31 patients. Acta Orthop Scand. 2004; 75(3): 249-251.
22. Narayanan UG, Hyman JE, Wainwright AM, Rang M, Alman BA. Complications of elastic stable intramedullary nail fixation of pediatric femoral fractures, and how to avoid them. J Pediatr Orthop. 2004; 24(4): 363-369.
23. Luhmann SJ, Schootman M, Schoenecker PL. Complications of titanium elastic nails for pediatric femoral shaft fractures. J Pediatr Orthop. 2003; 23(4): 443-447.
24. Salem KH, Keppler P. Limb geometry after elastic stable nailing for pediatric femoral fractures. J Bone Joint Surg Am. 2010 Jun;92(6):1409-1417.
25. Ozdemir HM, Yensel U, Senaran H. Immediate percutaneous intramedullary fixation and functional bracing for the treatment of pediatric femoral shaft fracture. J Pediatr Orthop. 2003; 23(4): 453-457.
26. Cramer KE, Tornetta P 3rd, Spero CR. Ender rod fixation of femoral shaft fractures in children. Clin Orthop Relat Res. 2000; 376: 119-123.

Downloads

Published

2019-04-15

How to Cite

Outcome of Elastic Intramedullary Nailing for the Treatment of Paediatric Femoral Shaft Fractures. (2019). Journal of Pakistan Orthopaedic Association, 30(4), 175-178. https://jpoa.org.pk/index.php/upload/article/view/281

Similar Articles

1-10 of 219

You may also start an advanced similarity search for this article.