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Elastic stable intramedullary nailing in paediatric traumatology at Yopougon Teaching Hospital (Abidjan)
T H Odéhouri-Koudou1, J C Gouli, J B Yao Kreh
1Department of Paediatric Surgery, Yopougon Teaching Hospital, Abidjan, Côte d'Ivoire. odehouri@voila.fr
Insights
Elastic stable intramedullary nailing is a safe and effective technique for treating pediatric fractures, offering good outcomes with minimal complications. This method ensures solid bone consolidation and promotes full recovery of motion in most young patients.
Area of Science:
- Pediatric Orthopedics
- Surgical Techniques
- Traumatology
Background:
- Elastic stable intramedullary nailing (ESIN) has significantly advanced pediatric fracture management.
- This technique offers a minimally invasive approach for treating various bone fractures in children.
Purpose of the Study:
- To evaluate the clinical experience and outcomes of ESIN for pediatric fractures.
- To assess the efficacy, safety, and complication profile of ESIN in a pediatric population.
Main Methods:
- A retrospective study was conducted on 38 children with 41 fractures treated with ESIN.
- Data collected included demographics, fracture patterns, surgical details, and patient outcomes.
- Follow-up assessments evaluated union, range of motion, and complications.
Main Results:
- ESIN was applied to femur, humerus, tibia/fibula, forearm, and radial neck fractures.
- Solid consolidation was achieved in all cases with no delay in union.
- Minor adverse events (skin irritation, transient knee limitation) and complications (malunion, stiffness) were reported but generally manageable.
Conclusions:
- Elastic stable intramedullary nailing is a straightforward and effective surgical option for pediatric fractures.
- Proper technique application leads to a low rate of complications and successful patient recovery.
Context:
Elastic stable intramedullary nailing has revolutionised the treatment of fractures in children.
Aim:
To report our experience with this current technique of management of fractures in children.
Methods And Materials:
A retrospective study of all children with fractures treated by this method from November 2003 to June 2006 at the Paediatric Surgery Department of Yopougon Teaching Hospital, Abidjan, Côte d'Ivoire. Data were recorded from their medical charts regarding demographics, fracture patterns, associated injuries, morbidity, and outcome.
Results:
A total of 38 children (14 boys; mean age, 11.7 years; range, 9-15 years) with 41 fractures, sited at femur (n=15), humerus (n=8), tibia and fibula (n=6), forearm (n=7), and radial neck (n=5), associated with other injuries in 7 cases, were enrolled in the study. The mean interval for surgery was 6.8 days. Open reduction was required 5 times (12.1%). The hospital stay was in the range 5-12 days. Minor adverse events were 1 (2.4%) early tibial loss of reduction, 3 (7.3%) skin irritations and 2 (4.8%) transient knee limitations. Complications (17.3%) included 2 axial (4.8%) and 1 rotational (2.4%) femoral malunions below 15°; 3 elbow (7.3%) and 1 knee stiffness (2.4%) in openly reduced cases. Solid consolidation was achieved in all cases, with no disturbance in standard union times. At a mean follow-up period of 16 months (range, 9-28 months), all but 3 patients with opened joints recovered full range of motion, and none showed either limp and gait anomalies or re-fracture after removal of wires.
Conclusion:
Elastic stable intramedullary nailing in children fractures is easy to perform and has little complications if a proper technique is used.
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