FLEXIBLE INTRAMEDULLARY NAIL FIXATION IN PEDIATRIC FEMORAL SHAFT FRACTURES

Year 2023, , 1 - 9, 31.08.2023

Şahin Çepni , Ali Şahin , Özay Subaşı

https://doi.org/10.55895/sshs.837201

Abstract

Abstract
Purpose: To evaluate the functional and radiological results of intramedullary fixation with elastic titanium nails in pediatric patients between the ages of 4 and 12 years with fractures of the femoral shaft.
Methods: We retrospectively evaluated 26 patients who were treated with titanium elastic nailing in the orthopedics and traumatology clinic of Erzurum Regional Training and Research Hospital between 2016 and 2018.
Results: The average age of the patients was 8.4 ± 2.21 years (range: 4-12). Twelve (46.1%) had oblique fractures, 9 (34.6%) transverse, and 5 (19.2%) spiral. The mean follow-up period was 19.24 ± 3.84 months (range: 12-32). Complete fracture union was achieved at an average of 8.20 ± 2.06 weeks (range: 5-13). In the first postoperative year, all patients had full range of motion in the hips and knees, and there were no angular deformities. Four patients (15.3%) had leg length discrepancy of less than 2 cm and 1 patient (3.8%) more than 2 cm. In our patients, mean varus-valgus angulation was 7.14° ± 5.18° (range: 0°-16°), and mean sagittal angulation was 3.47° ± 2.86° (range: 0°-14°).
Conclusion: Although there are different treatment options for femoral shaft fractures in children aged 4-12, we believe that titanium elastic nail fixation should be the first treatment option.
Özet
Amaç: Bu çalışmamızda, 4 ile 12 yaş arasındaki femur cisim kırıklı çocuk hastalarda elastik titanyum çivi ile intramedüller tespit uygulanan femur kırıklarının fonksiyonel ve radyolojik sonuçlarını değerlendirmek
Yöntemler: 2016 ile 2018 yılları arasında, femur diafiz kırığı nedeniyle intramedüller elastik çivi ile tedavi edilen 26 hasta incelendi.
Bulgular: Hastaların ortalama yaşı 8,4±2,21 (4-12 yaş) olarak tespit edildi. Bütün kırıklar femur diyafizinde idii ve hepsi kapalı kırıktı. Kırıkların 12'si (%46,1) oblik, 9’u (%34,6) transvers, 5'i (%19,2) spiraldi. Ortalama ameliyat süresi 48,54±11,24 (35-80 dk) dakika olarak bulundu. Hastaların ortalama takip süresi 19,24±3,84 (12-32) ay idi. Ortalama 8,20±2,06 (5-13) haftada tam kaynama saptandı. Ortalama 8,87±1,7 (6-13) ayda implantlar çıkartıldı. Ameliyat sonrası birinci yılda tüm hastaların kalça ve diz hareket genişlikleri tamdı ve klinik olarak rotasyonel veya açısal deformite saptanmadı. 5 hastada (%19,2) bacak uzunluğunda 2 cm’den az eşitsizlik görüldü. Hastalarımızda ortalama 9,14±5,18 derecelik (0°-18°) varus-valgus açılanması, sagital plandada ortalama 3,47±2,86 derecelik (0°-14°) açılanma görüldü.
Sonuç: 4 ile 12 yaş arasındaki çocuklarda femur cisim kırıklarında farklı tedavi seçenekleri olsa da titanyum elastik çiviyle tespitin ilk düşünülmesi gereken tedavi seçeneği olması gerektiği görüşündeyiz.

Keywords

pediatric, femur fracture, titanium elastic nails

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