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Related Concept Videos

Fractures: Bone Repair01:27

Fractures: Bone Repair

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
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Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
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Titanium elastic intramedullary nailing: closed or mini-open reduction?

Bekir Yavuz Uçar1, Mehmet Gem, Mehmet Bulut

  • 1Department of Orthopaedic Surgery, Dicle University Medical Faculty, Diyarbakir, Turkey. drbyucar@yahoo.com

Acta Orthopaedica Belgica
|November 12, 2013
PubMed
Summary

Titanium elastic nailing (TEN) for pediatric femoral fractures showed no significant difference between closed and mini-open reduction. Mini-open reduction reduced operative time and radiation exposure but increased blood loss and hospital stay.

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Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling
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Area of Science:

  • Pediatric Orthopedics
  • Surgical Techniques
  • Biomaterials

Background:

  • Femoral fractures are common in children.
  • Titanium elastic nailing (TEN) is a widely used fixation method.
  • Comparing reduction techniques is crucial for optimizing outcomes.

Purpose of the Study:

  • To compare the outcomes of closed versus mini-open reduction in pediatric femoral fractures treated with TEN.
  • To evaluate operative time, fluoroscopy time, blood loss, and clinical outcomes.

Main Methods:

  • Retrospective study of 43 children with femoral fractures treated with TEN.
  • Group I: 22 children underwent closed fluoroscopic reduction.
  • Group II: 21 children underwent mini-open reduction.

Main Results:

  • Mini-open reduction (Group II) had significantly shorter operation time (48 min vs 71 min) and fluoroscopy time (35.5s vs 793s) compared to closed reduction (Group I).
  • Group II experienced significantly higher blood loss and longer hospital stay.
  • No significant differences were observed in time to full weight bearing, radiographic union, or TEN outcome scores.

Conclusions:

  • Neither closed nor mini-open reduction technique was definitively superior for pediatric femoral fractures treated with TEN.
  • Mini-open reduction offers benefits in reduced operative and radiation time.
  • Intra-operative conversion to mini-open reduction may be considered if closed reduction is challenging.