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Submuscular plates versus flexible nails in preadolescent diaphyseal femur fractures

L-K Chen1, B T Sullivan1, P D Sponseller1

  • 1Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland, USA.

Journal of Children'S Orthopaedics
|October 9, 2018
PubMed

Insights

Flexible nails (FNs) offer advantages over submuscular plates (SMPs) for pediatric femur fractures, reducing operative time and blood loss. FNs also led to shorter hospital stays, making them a potentially more efficient treatment option.

Area of Science:

  • Orthopedic surgery
  • Pediatric trauma
  • Biomedical engineering

Background:

  • Diaphyseal femur fractures are common in children.
  • Submuscular plates (SMPs) and flexible nails (FNs) are surgical options.
  • Outcomes of these methods require comparative analysis.

Purpose of the Study:

  • To compare patient characteristics, operative time, blood loss, hospital stay, and complications.
  • The study focuses on pediatric diaphyseal femur fractures.
  • Comparison is between submuscular plates (SMPs) and flexible nails (FNs).

Main Methods:

  • Retrospective review of 58 children with diaphyseal femur fractures.
  • Treatment groups: 30 with SMPs and 28 with FNs (2005-2017).
  • Exclusion criteria: pathological fractures and musculoskeletal comorbidities.

Main Results:

  • FNs associated with significantly shorter operative time for insertion and removal compared to SMPs.
  • FNs demonstrated less estimated blood loss (EBL) during insertion (p < 0.001).
  • The FN group experienced a shorter length of hospital stay (LOS) post-insertion (p = 0.032).

Conclusions:

  • Flexible nails (FNs) are associated with reduced operative time and EBL for insertion.
  • FNs also correlate with a shorter post-insertion LOS in pediatric diaphyseal femur fractures.
  • Both methods had comparable rates of surgical site infections; implant irritation was more common with FNs.
Abstract

Keywords:
diaphyseal femur fractureflexible nailingskeletally immature childrensubmuscular platingsurgical characteristics

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