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COMPARISON BETWEEN FLEXIBLE NAILING AND EXTERNAL FIXATION, METHODS TO STABILIZE FEMORAL SHAFT FRACTURES IN THE
Breno Augusto Giese Ribeiro1, Caio Henrique Kenchian1, Guilherme Satake1
1Universidade Federal de São Paulo, Esco Paulista de Medicina, São Paulo, SP, Brazil.
Insights
Flexible intramedullary nailing and external fixation are common pediatric femur fracture treatments. Flexible nailing shows greater acceptance and validity compared to external fixation for pediatric femoral fractures.
Area of Science:
- Orthopedic surgery
- Pediatric traumatology
- Biomedical engineering
Background:
- Pediatric femur fractures are frequently managed with flexible intramedullary nailing or external fixation.
- Comparative analysis of these surgical techniques is essential for optimizing treatment outcomes.
- Understanding associated complications is crucial for patient safety and effective management.
Purpose of the Study:
- To systematically review and compare clinical and radiographic outcomes of flexible intramedullary nailing versus external fixation for pediatric femur fractures.
- To investigate and evaluate complications associated with each surgical method.
Main Methods:
- Systematic literature review adhering to PRISMA guidelines.
- Searches conducted across PubMed, Embase, and Web of Science databases (January-August 2023).
- Inclusion of 11 articles detailing surgical treatment of 718 pediatric patients.
Main Results:
- Both flexible nailing and external fixation yield satisfactory clinical and radiographic results for pediatric femoral fractures.
- Common complications include malunion, infections, skin irritation, angular deformity, and limb length discrepancy.
- Flexible nailing demonstrated higher acceptance and perceived validity compared to external fixation.
Conclusions:
- Flexible intramedullary nailing is a preferred and more accepted surgical option for pediatric femur fractures.
- Both methods are viable, but flexible nailing offers advantages in clinical acceptance.
- Continued research into minimizing complications for both techniques is warranted.
Abstract:
Flexible intramedullary nailing and external fixation have become the main methods to surgically treat femur fractures in children. This study aimed to search the current literature and evaluate the clinical and radiographic results of surgical treatment by comparing these methods and investigating their associated complications. This systematic review was carried out following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) recommendations. Searches were carried out on the PubMed, Embase, and Web of Science databases. The search for journals in these databases was carried out from January 2023 to August 2023, retrieving 695 studies. This systematic review included 11 articles, which encompassed 718 patients who underwent surgical external fixation and flexible nailing. The most frequently observed complications referred to late or malunion, superficial and deep infections, skin irritation, angular deformity, and length discrepancy between lower limbs. Both methods of stabilization of pediatric femoral fractures can provide good clinical and radiographic results. However, the choice of treatment with flexible nails is certainly more valid and has greater acceptance than external fixation. .
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