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[Treatment of pediatric fractures by intramedullary stable elastic pinning]
O Reinberg1, P Frey, B J Meyrat
1Service de Chirurgie Pédiatrique, Centre Hospitalier Universitaire Vaudois, Lausanne-CHUV.
Insights
Elastic stable intramedullary pinning is a minimally invasive technique for pediatric long bone fractures. This method promotes early healing and excellent outcomes in children, allowing for quick recovery and physical activity.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Traumatology
Background:
- New techniques for pediatric fractures aim for mechanical stability while preserving fracture gap instability for enhanced callus formation.
- Dynamic external fixation and elastic stable intramedullary pinning are established treatments for pediatric long bone fractures.
Purpose of the Study:
- To evaluate the clinical experience with elastic stable intramedullary pinning in treating pediatric long bone fractures over a seven-year period.
Main Methods:
- Retrospective analysis of 105 pediatric fractures treated with elastic stable intramedullary pinning.
- Inclusion of fractures of the femur, humerus, forearm, and tibial shaft.
Main Results:
- The technique demonstrated effectiveness in supporting natural fracture healing in growing bones.
- Associated with minimal invasiveness, cost-effectiveness, and short hospital stays.
- Facilitated early consolidation, enabling prompt return to physical activity with rare complications and excellent outcomes.
Conclusions:
- Elastic stable intramedullary pinning is a safe and effective method for pediatric long bone fractures.
- Offers significant advantages including minimally invasive approach, cost-effectiveness, and superior functional and cosmetic results.
Abstract:
During the past decade several new techniques for the treatment of children's fractures respecting the specificity of the growing bone have been described. The goal of all these techniques was to mechanically stabilise the fracture however to preserve a certain instability of the fracture gap itself inducing early callus formation and subsequent consolidation. The dynamic external fixation as well as the elastic stable intramedullary pinning have become accepted means in the treatment of long bone fractures in the paediatric age group. We report our experience of the last seven years with the intramedullary pinning of 105 fractures. Eighty-four were fractures of the femur, 9 of the humerus, 8 of the forearm, and a further 4 of the tibial shaft. The intramedullary elastic pinning represents a simple technique which supports or even enhances the natural process of fracture healing of the growing bone. The method is not very invasive, is cost effective, and allows short hospitalisation. Early physical activity is guaranteed due to early consolidation of the fracture. Complications are rare and the final orthopedic and cosmetic outcome is excellent.