Abstract
Objective:To analyze outcomes of treatment and complications in children treated with elastic stable intramedullary nailing (ESIN) due to femoral fracture.Methods:From May 2002 until May 2018 case records of 103 patients (76 male and 27 female), with median age of 9 (range, 3-17) and follow-up of 92 months, who underwent ESIN because of displaced femoral fracture were retrospectively reviewed. The patient’s information including age, sex, side involved, trauma mechanism, type of fracture, associated injuries, neurovascular status, complications, operation time, duration of hospital stay, time to implant removal were analyzed. The surgical procedure implied a reposition of bone fragments and osteosynthesis with titanium elastic nails introduced through an incision over the lateral and medial border of the distal femoral metaphysis. Results:All patients achieved complete radiographic healing at a mean of 8.5 (range, 5-15) weeks. Nine (8.49%) postoperative complications were recorded: three entry site skin irritation, two cases of valgus angulation and one case of nail protrusion, re-fracture, Varus angulation and delayed union. All complications, except case of re-fracture and one valgus angulation, were treated conservatively, with no long term consequences for the patients. Two patients were re-operated. After removal of nails all patients recovered complete function of the extremity, without long term consequences.Conclusion:The ESIN for treatment of femoral fractures shows very good functional and cosmetic results. It allows an early functional and cast-free follow-up with a quick pain reduction. Because of the excellent objective and subjective results, the operative stabilization of femoral fractures with ESIN should be recommended to all pediatrics patients
Highlights
Fractures of the femoral diaphysis comprise around 4 % of all long-bone fractures in children [1, 2], and this is the second most frequent site affecting the lower extremity [3,4,5], and unlike femoral fractures in adults isolated fractures of femoral diaphysis are often seen [6]
Long bone fractures are among the most common emergencies in most trauma centers of the world. In children, such fractures can usually be successfully treated with proper closed reduction and immobilization, there are cases where surgical stabilization and osteosynthesis is needed
The ESIN has been promoted to the real gold standard of long bone fractures treatment in children
Summary
Fractures of the femoral diaphysis comprise around 4 % of all long-bone fractures in children [1, 2], and this is the second most frequent site affecting the lower extremity [3,4,5], and unlike femoral fractures in adults isolated fractures of femoral diaphysis are often seen [6]. We hypothesized that the ESIN as a treatment for femoral fractures in children would give satisfactory results and allow early functional follow-up with a quick pain reduction and low complication rate. The objective of this study was to evaluate the clinical and radiological outcomes and complication rates of femoral fractures treated by ESIN in children in a cohort of 103 children over the past 15 years to underline the safeness and efficiency of this technique
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
