Comparison of clinical and radiological outcomes of titanium elastic nail and Kirschner wire in the treatment of pediatric tibia diaphyseal fractures
Öz
Purpose: The aim of this study was to compare the clinical and radiological results of paediatric tibia shaft fractures treated by intramedullary fixation with Kirschner (K) wire and titanium elastic nail (TEN).
Materials and Methods: Thirtynine patients were evaluated retrospectively. Included 20 patients treated with TEN (group 1) and 19 patients treated with K-wire (group 2). At the end of the 1-year follow-up, radiological measurements for malalignment and the Flynn TEN outcome scoring system were used to compare the clinical results.
Results: According to the Flynn classification, in group 1, results were excellent in 75% and good in 25%, and in group 2, excellent in 70% and good in 30%. In any cases has not been experienced physeal early closure or refracture, nor did they need re-manipulation or re-operation, and no implant insufficiency was detected. Malalignment was found in four patients in group 1, and in two patients in group 2 of lesser than 10 degrees.
Conclusions: Even though two methods showed similar clinical and radiological results, fixation paediatric tibial fractures with K-wire may have some advantages as lower-cost and easy accessibility according to TEN.
Anahtar Kelimeler
pediatric tibia fracture, titanium elastic nail, kirschner wire
Kaynakça
- 1. Lieber J, Schmittenbecher P. Developments in the treatment of pediatric long bone shaft fractures. Eur J Pediatr Surg. 2013;23: 427–33.
- 2. Mashru RP, Herman MJ, Pizzutillo PD.Tibial shaft fractures in children and adolescents. J Am Acad Orthop Surg 2005;13:345-52.
- 3. Shannak AO.Tibial fractures in children: follow-up study. J Pediatr Orthop 1988;8 :306-310.
- 4. Qidwai SA.Intramedullary Kirschner wiring for tibia fractures in children. J Pediatr Orthop 2001;21:294-7.
- 5. Nirav K Pandya, Flexible Intramedullary Nailing of Unstable and/or Open Tibia Shaft Fractures in the Pediatric Population; J Pediatr Orthop 2016 Jun;36 Suppl 1:S19-23.
- 6. Blasier RD, Barnes CS. Age as a prognostic factor in open tibial fractures in children. Clin Orthop Relat Res1996;331:261-4.
- 7. Flynn JM, Hresko T, Reynolds RA, Blasier RD, Davidson R, Kasser J. Titanium elastic nails of paediatric femur fractures: a multicenter study of early results with analysis of complications. J Pediatr Orthop 2001;21:4-8.
- 8. Carey TP, Galpin RD. Flexible intramedullary nail fixation of paediatric femoral fractures. Clin Orthop Relat Res 1996;332:110-8.
- 9. Metaizeau JP.Stable elastic intramedullary nailing for fractures of the femur in children. J Bone Joint Surg Br 2004;86:954-7.
- 10. Linhart WE, Roposch A. Elastic stable intramedullary nailing for unstable femoral 24-fractures in children: preliminary results of a new method. J Trauma 1999;47:372-8.
