Femur Fractures in Older Children and Adolescents Treated by the Sign Intramedullary Nail
Tapia-Pena Telmo1* and Tapia Abril Juan-Claude2
1Hospital Vicente Corral Moscoso, MSP, Cuenca, Ecuador
2Hospital Municipal de la Mujer y El Niño, Cuenca, Ecuador
*Corresponding Author:Tapia-Peña Telmo, Hospital Vicente Corral Moscoso, MSP, Cuenca, Ecuador.
Received:
June 22, 2022; Published: August 09, 2022
Abstract
Objectives: To evaluate the clinical results of intramedullary nailing of femoral shaft fractures using a rigid intramedullary SIGN nail in older children and adolescents. Is it safe to use it on this group of age?
Design: A retrospective study was carried out evaluating all skeletally immature patients with femoral shaft fractures treated with the SIGN nail system at the Vicente Corral Moscoso Hospital, Cuenca, Ecuador.
Patients/Participants: Thirty-four children and adolescents with displaced femoral fractures and one case of non-union of the femur and open growth plates.
Main Outcome Measurements: Patients were evaluated to determine hospital stay, time to union, final fracture alignment, complications, proximal femoral changes including avascular necrosis or proximal femoral valgus with femoral neck narrowing.
Results: The average age of the patients was 12 years old (range from 8 to 17 years). Fractures healed at a mean of 6 weeks (range 5-14 weeks) after a fracture. The average hospital stay for patients with isolated femur fractures was 2.8 days (range 1-5 days). At an average follow-up of 57 weeks, no patient had developed malunion, avascular necrosis, femoral neck valgus, or femoral neck narrowing. Patients were followed for a minimum of 6 weeks (range: 6 - 351 weeks). The SIGN intramedullary nail provided a quick, first quality solution in osteosynthesis of diaphyseal fractures of the femur, without affecting the budget of the institution.
Keywords:Femoral Shaft Fractures; Antegrade Intramedullary Nailing; Femur; Femur Fractures in Children and Adolescents
References
- Flynn JM and Schwend RM. “Management of pediatric femoral shaft fractures”. Journal of the American Academy of Orthopaedic Surgeons 5 (2004): 347-350.
- Poolman RW., et al. “Pediatric femoral fractures: A systematic review of 2422 cases”. Journal of Orthopaedic Trauma 9 (2006): 648-654.
- Keeler KA., et al. “Antegrade intramedullary nailing of pediatric femoral fractures using an interlocking pediatric femoral nail and a lateral trochanteric entry point”. Journal of Pediatric Orthopaedics 4 (2009): 345-351.
- Beaty JH. “Femoral Shaft fractures in children and adolescents”. Journal of the American Academy of Orthopaedic Surgeons 3 (1995): 207-2017.
- Beaty JH. “Operative treatment of femoral Shaft fractures in children and adolescents”. Clinical Orthopaedics and Related Research (2005): 114-122.
- Wolinsky PR., et al. “Reamed intramedullary nailing of the femur: 551 cases”. Journal of Trauma3 (1999): 392-399.
- Robert Brumback MD., et al. “Intramedullary Nailing of the femur reamed versus non reamed”. Journal of the American Academy of Orthopaedic Surgeons (2000): 83-90.
- Barlas K and Beg H. “Flexible intramedullary nailing versus external fixation of paediatric femoral fractures”. Acta Orthopaedica Belgica 2 (2006): 159-163.
- Salem KH and Keppler P. “Limb geometry after elastic stable nailing for pediatric femoral fractures”. The Journal of Bone and Joint Surgery. American 6 (2010): 1409-1417.
- Miller DJ., et al. “Locked Intramedullary nailing in the treatment of femoral shaft fractures in children younger than 12 years of age: indications and preliminary report of outcomes”. Journal of Pediatric Orthopaedics8 (2012): 777-780.
- Hosalkar H., et al. “Intramedullary Nailing of Pediatric Femoral Shaft Fracture”. Journal of the American Academy of Orthopaedic Surgeons 8 (2011): 472-481.
- Kuremsky MA and Frick SL. “Advances in the surgical management of pediatric femoral shaft fractures”. Current Opinion in Pediatrics1 (2007): 51-57.
- Zirkle L. “Introducción. Techniques in Orthopaedics” 24.4 (2009): 229.
- signfracturecare.org
- González-Herranz P., et al. “Intramedullary nailing of the femur in children: Effects on its proximal end”. The Journal of Bone and Joint Surgery British2 (1995): 262-266.
- Raney EM., et al. “Premature greater trochanteric epiphysiodesis secondary to intramedullary femoral rodding”. Journal of Pediatric Orthopaedics 4 (1993): 516-520.
- Grosse A., et al. “Treatment of fragments, loss of bony substance and pseudarthrosis of femur and tibia using screw fixation (40 cases) [in French]”. Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 2 (1978): 33-35.
- Kempf I., et al. “Closed locked intramedullary nailing. Its application to comminuted fractures of the femur”. The Journal of Bone and Joint Surgery. American 67.5 (1985): 709-720.
- Klemm K and Schellmann WD. “Dynamic and static locking of the intramedullary nail [in German]”. Monatsschr Unfallheilkd Versicher Versorg Verkehrsmed 75.12 (1972): 568-575.
- acumed.net
- Foltz Michelle MD. “A leg to stand on, Universe, Inc. IX (2009).
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