Elastic nailing in diaphyseal fractures of femur in children
Background: Fracture shaft femur in children is conventionally managed by traction followed by hip spica. Prolonged hospitalization, difficulty in maintaining child with traction for 3 weeks, then hip spica makes toileting and personal hygiene difficult. This may cause malunion/limb length discrepan...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2018-01-01
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| Series: | Journal of Orthopedics, Traumatology and Rehabilitation |
| Subjects: | |
| Online Access: | http://www.jotr.in/article.asp?issn=0975-7341;year=2018;volume=10;issue=2;spage=107;epage=111;aulast=Kumar |
| _version_ | 1818339846417022976 |
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| author | Pawan Kumar Dasarath Kisan |
| author_facet | Pawan Kumar Dasarath Kisan |
| author_sort | Pawan Kumar |
| collection | DOAJ |
| description | Background: Fracture shaft femur in children is conventionally managed by traction followed by hip spica. Prolonged hospitalization, difficulty in maintaining child with traction for 3 weeks, then hip spica makes toileting and personal hygiene difficult. This may cause malunion/limb length discrepancies, rotational deformities, and sometimes psychological problems. Materials and Methods: A total of 32 children in the age group of 4-16years,25 boys and 7 girls having diaphyseal femoral fractures were stabilized with two stainless steel/titanium elastic nail retrograde way under fracture table. The average duration of surgery was 45 min (30–75 min). Patients were assessed clinically and radiologically before and after surgery for 2 years. Early mobilization and weight-bearing allowed. The results were evaluated using the criteria of Flynn et al. Technical problems and complications were also analyzed. Results: Duration of hospitalization was 4 days (3–7 days). The average duration of appearance of bridging callus was 6 weeks. Radiological union in all cases was achieved in a mean time of 8.7 weeks. All children showed sound union at an average 8 weeks without significant complications. Return to school was early with an average 10–12 weeks. Result assessed for range of motion (ROM), irritation at the distal end of the nail, pain, deformity, limb length discrepancies, union, and malunion. Overall results observed were excellent in 24, satisfactory in 5 and poor in 3 patients. The soft-tissue discomfort near the knee produced by the nail ends was the most common problem encountered. Three patients had decreased terminal ROM at the knee. Later, all the 32 patients had full ROM at hip and knee after 3 months. Conclusion: Elastic nailing in pediatrics femoral shaft fracture-simple and effective, small incisions, biological, dynamic fixation, early mobilization, rapid wound healing, rapid functional recovery. |
| first_indexed | 2024-12-13T15:33:30Z |
| format | Article |
| id | doaj.art-2b03bf2f675d483eb4e1ebee191bea0d |
| institution | Directory Open Access Journal |
| issn | 0975-7341 |
| language | English |
| last_indexed | 2024-12-13T15:33:30Z |
| publishDate | 2018-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Orthopedics, Traumatology and Rehabilitation |
| spelling | doaj.art-2b03bf2f675d483eb4e1ebee191bea0d2022-12-21T23:40:06ZengWolters Kluwer Medknow PublicationsJournal of Orthopedics, Traumatology and Rehabilitation0975-73412018-01-0110210711110.4103/jotr.jotr_3_18Elastic nailing in diaphyseal fractures of femur in childrenPawan KumarDasarath KisanBackground: Fracture shaft femur in children is conventionally managed by traction followed by hip spica. Prolonged hospitalization, difficulty in maintaining child with traction for 3 weeks, then hip spica makes toileting and personal hygiene difficult. This may cause malunion/limb length discrepancies, rotational deformities, and sometimes psychological problems. Materials and Methods: A total of 32 children in the age group of 4-16years,25 boys and 7 girls having diaphyseal femoral fractures were stabilized with two stainless steel/titanium elastic nail retrograde way under fracture table. The average duration of surgery was 45 min (30–75 min). Patients were assessed clinically and radiologically before and after surgery for 2 years. Early mobilization and weight-bearing allowed. The results were evaluated using the criteria of Flynn et al. Technical problems and complications were also analyzed. Results: Duration of hospitalization was 4 days (3–7 days). The average duration of appearance of bridging callus was 6 weeks. Radiological union in all cases was achieved in a mean time of 8.7 weeks. All children showed sound union at an average 8 weeks without significant complications. Return to school was early with an average 10–12 weeks. Result assessed for range of motion (ROM), irritation at the distal end of the nail, pain, deformity, limb length discrepancies, union, and malunion. Overall results observed were excellent in 24, satisfactory in 5 and poor in 3 patients. The soft-tissue discomfort near the knee produced by the nail ends was the most common problem encountered. Three patients had decreased terminal ROM at the knee. Later, all the 32 patients had full ROM at hip and knee after 3 months. Conclusion: Elastic nailing in pediatrics femoral shaft fracture-simple and effective, small incisions, biological, dynamic fixation, early mobilization, rapid wound healing, rapid functional recovery.http://www.jotr.in/article.asp?issn=0975-7341;year=2018;volume=10;issue=2;spage=107;epage=111;aulast=Kumarelastic nailingintramedullary nailpediatric femoral fractures |
| spellingShingle | Pawan Kumar Dasarath Kisan Elastic nailing in diaphyseal fractures of femur in children Journal of Orthopedics, Traumatology and Rehabilitation elastic nailing intramedullary nail pediatric femoral fractures |
| title | Elastic nailing in diaphyseal fractures of femur in children |
| title_full | Elastic nailing in diaphyseal fractures of femur in children |
| title_fullStr | Elastic nailing in diaphyseal fractures of femur in children |
| title_full_unstemmed | Elastic nailing in diaphyseal fractures of femur in children |
| title_short | Elastic nailing in diaphyseal fractures of femur in children |
| title_sort | elastic nailing in diaphyseal fractures of femur in children |
| topic | elastic nailing intramedullary nail pediatric femoral fractures |
| url | http://www.jotr.in/article.asp?issn=0975-7341;year=2018;volume=10;issue=2;spage=107;epage=111;aulast=Kumar |
| work_keys_str_mv | AT pawankumar elasticnailingindiaphysealfracturesoffemurinchildren AT dasarathkisan elasticnailingindiaphysealfracturesoffemurinchildren |