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Elastic stable intramedullary nailing for pediatric long bone fractures: experience with 175 fractures
D Furlan1, Z Pogorelić, M Biočić
1Department of Pediatric Surgery, University Hospital Split and Split University School of Medicine, Split, Croatia.
Insights
Elastic stable intramedullary nailing effectively treats displaced long bone fractures in children, offering excellent functional and cosmetic outcomes with minimal invasiveness. This method allows for early recovery and pain reduction.
Area of Science:
- Pediatric Orthopedics
- Surgical Innovation
- Traumatology
Background:
- Displaced long bone shaft fractures are common in skeletally immature children.
- Intramedullary fixation is a standard surgical approach for fracture management.
Purpose of the Study:
- To evaluate the efficacy of elastic stable intramedullary nailing (ESIN) for treating displaced long bone shaft fractures in pediatric patients.
- To assess functional and cosmetic outcomes, complication rates, and patient satisfaction following ESIN.
Main Methods:
- Retrospective review of 173 pediatric patients treated with titanium elastic stable intramedullary nails for long bone fractures.
- Analysis of fracture types (humeral, forearm, femur, tibia), patient demographics, and follow-up duration (mean 41.3 months).
- Assessment of subjective patient satisfaction and complication incidence.
Main Results:
- Complete fracture healing achieved in all patients within a mean of 7.5 weeks.
- A low complication rate of 6.3% (11 patients), including neuropraxia, skin irritation, wire protrusion, and infection.
- High patient satisfaction reported, with 89% very satisfied and 11% satisfied.
Conclusions:
- Elastic stable intramedullary nailing is a highly effective, minimally invasive treatment for pediatric long bone fractures.
- ESIN provides excellent functional and cosmetic results, enabling early mobilization and pain relief.
- This technique is recommended as the preferred method for managing these fractures in children.
Purpose:
To demonstrate the effectiveness of intramedullary fixation of displaced long bones shaft fractures in skeletally immature children using the elastic stable intramedullary nails.
Patients And Methods:
The case records of 173 children who underwent fixation with titanium intramedulary nails because of long bones fractures were reviewed. The average age of the patients was 11.7 years, and mean follow-up was 41.3 months. There were 55 humeral, 42 forearm, 42 femoral and 36 tibial fractures. Subjective satisfaction was assessed.
Results:
All patients achieved complete healing at a mean of 7.5 weeks. Complications were recorded in 11 (6.3%) patients and included: one neuropraxia, six entry site skin irritations, two protrusions of the wires through the skin and two skin infections at the entry site. In a subjective measure of outcome at follow-up, 89% of patients were very satisfied and 11% satisfied; no patients reported their outcome as not satisfied. The implants were removed at a median time of six months from the index operation.
Conclusion:
Elastic Stable Intra-medullary Nailing is the method of choice for the pediatrics patients, because it is minimaly invasive and shows very good functional and cosmetic results. It allows an early functional and cast-free follow-up with a quick pain reduction.
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