[A COMPARATIVE STUDY ON TWO FIXATION METHODS FOR BENIGN LONG BONE PATHOLOGICAL FRACTURES IN CHILDREN]
Insights
Elastic intramedullary nails are a better first choice than locking compression plates for treating pediatric benign long bone fractures, offering faster healing and lower costs. Both methods show good long-term outcomes with similar recurrence rates.
Area of Science:
- Pediatric Orthopedics
- Skeletal Pathologies
- Surgical Techniques
Background:
- Benign long bone pathological fractures in children require effective surgical stabilization.
- Choosing the optimal fixation method is crucial for patient recovery and minimizing complications.
Purpose of the Study:
- To compare the clinical effectiveness of elastic intramedullary nails versus locking compression plates for benign long bone pathological fractures in pediatric patients.
- To provide evidence-based guidance for selecting the most appropriate surgical intervention.
Main Methods:
- A randomized controlled trial involving 72 children with benign long bone pathological fractures.
- Patients were divided into two groups: elastic intramedullary nail fixation (n=33) and locking compression plate fixation (n=39).
- Comparative analysis of operative time, blood loss, costs, fracture healing, recurrence, and functional outcomes.
Main Results:
- Elastic intramedullary nail group demonstrated significantly shorter operation times, reduced intraoperative blood loss, and lower overall costs compared to the locking compression plate group.
- Faster fracture healing was observed in the elastic intramedullary nail group.
- Both fixation methods showed no significant differences in recurrence rates and achieved excellent functional outcomes at long-term follow-up.
Conclusions:
- Elastic intramedullary nail fixation is recommended as the primary treatment option for benign long bone pathological fractures in children.
- Locking compression plate fixation serves as a viable secondary option when indicated.
Objective:
To compare the effectiveness of locking compression plate and elastic intramedullary nail for the treatment of benign long bone pathological fractures in children, so as to provide the evidence for clinical treatment.
Methods:
Seventy-two children with long bone pathological fractures who accorded with the inclusion criteria between January 2005 and July 2013 were randomly divided into 2 groups. Fracture was fixed with elastic intramedullary nail in 33 cases (group A) and with locking compression plate in 39 cases (group B). There was no significant difference in sex, age, body mass index, primary lesion, location of fracture, side of fracture, and interval between injury and operation between 2 groups (P > 0.05).
Results:
Group A had shorter operation time, less intraoperative blood loss, and less overall costs than group B, showing significant differences (P < 0.05). Primary healing of incision was obtained. All the patients were followed up 1-7 years (mean, 3.4 years). Tumor lesions disappeared and the pathological fracture healed after operation by X-ray film observation, and group A had faster fracture healing time than group B (P < 0.05). There was no loosening and displacement of internal fixation, bone resorption, and bone defect nonunion in 2 groups. Recurrence was found in 2 cases (6.1%) of group A and 3 cases (7.7%) of group B, showing no significant difference (χ2 = 0.074, P = 0.580). Re-fracture was found in 1 patient with tibial bone cyst of group B after 3 months of operation, and healed after 1 year of open reduction and internal fixation. According to X-ray film and comprehensive function evaluation of shoulder, elbow, hip, knee, and ankle, the results were all excellent in 2 groups at last follow-up.
Conclusion:
Elastic intramedullary nail fixation should be the first choice, and locking compression plate should be the second choice for children with benign long bone pathological fractures.
