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Evaluation of Radiological and Functional Results of Long Bone Diaphyseal Fractures in Children Aged 5-15 Years Who Underwent Titanium Elastic Nail

Yıl 2022, Cilt: 8 Sayı: 4, 603 - 614, 30.11.2022
https://doi.org/10.19127/mbsjohs.1148801

Öz

Objective: In this study, we aimed to evaluate the radiological and functional results of titanium elastic nail (TEN), which was used as a surgical method in pediatric long bone diaphyseal fractures between 5-15 years of age, by comparing it with the clinical features of the patient and the fracture.
Methods: In this study, 44 patients (11 girls, 33 boys) aged 5-15 years (mean 9.86 ±2.84) were included. The clinical features of the patient, family satisfaction, evaluation of the fracture according to Flynn Criteria, time to bone union, stay in the hospital, and school absence was examined.
Results: TEN was applied mostly to the femur (n;18), tibia (n;14), and forearm (n;12) diaphysis fractures, respectively. Most of the fractures were seen as a result of high energy and closed middle diaphysis, the transverse fracture pattern was the most. Most of the fracture surgeries were performed with the closed method. The family satisfaction of the patients was at a high level. In the evaluation of fractures according to Flynn Criteria, most of the results were excellent, but no poor results were observed. Bone union time was higher in patients aged ten years and older and undergoing open surgery, and less in transverse fracture shape (p<0.05). The time not to attend school was highest in open fracture type, tibia fractures, and open surgery patients (p<0.05). Ulna union time was 13.1 ± 1.8 weeks, which was higher than forearm fractures (p<0.05). The hospital stay was 3.50 ± 0.79 / 4.29 ± 1.54 / 3.33 ± 0.49 days in femur/tibia/forearm fractures, respectively, and was the highest in tibia fractures (p<0.05).
Conclusions: TEN is an effective and safe method for long bone diaphyseal fractures in children aged 5-15 years, with low complication rates and positive effects on the patient and the health system.

Kaynakça

  • 1- Omeroglu H. Basic principles of fracture treatment in children. Eklem Hastalik Cerrahisi. 2018;29(1):52-7.
  • 2- Becker T, Weigl D, Mercado E, Katz K, Bar-On E. Fractures and refractures after femoral locking compression plate fixation in children and adolescents. J Pediatr Orthop. 2012;32(7):e40-6.
  • 3- Nisar A, Bhosale A, Madan SS, Flowers MJ, Fernandes JA, Jones S. Complications of Elastic Stable Intramedullary Nailing for treating paediatric long bone fractures. J Orthop. 2013;10(1):17-24.
  • 4- Khuntia S, Swaroop S, Patro BP, Sahu S. Paediatric Long Bone Fractures Managed with Elastic Intramedullary Nails: A Retrospective Study of 30 Patients. Cureus. 2020;12(4):e7847.
  • 5- Assaghir YM. Titanium elastic nail in femur fractures as an alternative to spica cast in preschoolers. J Child Orthop. 2012;6(6):505–11.
  • 6- Sutphen SA, Mendoza JD, Mundy AC, Yang JG, Beebe AC, Samora WP 3rd, et al. Pediatric Diaphyseal Femur Fractures: Submuscular Plating Compared with Intramedullary Nailing. Orthopedics. 2016;39(6):353-8.
  • 7- Govindasamy R, Gnanasundaram R, Kasirajan S, Ibrahim S, Melepuram JS. Elastic Stable Intramedullary Nailing of Femoral Shaft Fracture-Experience in 48 Children. Arch Bone Jt Surg. 2018;6(1):39-46.
  • 8- Uludağ A, Tosun HB. Treatment of Unstable Pediatric Tibial Shaft Fractures with Titanium Elastic Nails. Medicina. 2019;55(6):266.
  • 9- Pandya NK, Edmonds EW, Mubarak SJ. The incidence of compartment syndrome after flexible nailing of pediatric tibial shaft fractures. J Child Orthop. 2011;5(6):439–47.
  • 10- Flynn JM, Hresko T, Reynolds RA, Blasier RD, Davidson R, Kasser J. Titanium elastic nails for pediatric femur fractures: a multicenter study of early results with analysis of complications. J Pediatr Orthop. 2001;21(1):4–8.
  • 11- Imam MA, Negida AS, Elgebaly A, Hussain AS, ErnstbrunnerL, Javed S, et al. Titanium elastic nails versus spica cast in pediatric femoral shaft fractures: a systematic review and meta-analysis of 1012 patients. Arch Bone Jt Surg. 2018;6(3):176-88.
  • 12- Lascombes P, Haumont T, Journeau P. Use and abuse of flexible intramedullary nailing in children and adolescents. J Pediatr Orthop. 2006;26(6):827–34.
  • 13- Cai L, Wang J, Du S, Zhu S, Wang T, Chen H. Comparison of hybrid fixation to dual plating for both-bone forearm fractures in older children. Am J Ther. 2016;23(6):e1391–e96.
  • 14- Debnath S, Debbarma S, Sarkar A. Titanium elastic nailing osteosynthesis for diaphyseal tibial fracture in pediatrıc age group-our experience. Indian J Appl Res. 2017;7(7):52–3.
  • 15- Heo J, Oh CW, Park KH, Kim JW, Kim HJ, Lee JC, et al. Elastic nailing of tibia shaft fractures in young children up to 10 years of age. Injury. 2016;47(4):832–36.
  • 16- Kawalkar A, Badole CM. Percutaneous titanium elastic nail for femoral shaft fracture in patient between 5 and 15 years. J Orthop. 2018;15(2):695-700.
  • 17- Pennock AT, Bastrom TP, Upasani VV. Elastic Intramedullary Nailing Versus Open Reduction Internal Fixation of Pediatric Tibial Shaft Fractures. J Pediatr Orthop. 2017;37(7):e403-e8.
  • 18- Siddiqui AA, Abousamra O, Compton E, Meisel E, Illingworth KD. Titanium Elastic Nails Are a Safe and Effective Treatment for Length Unstable Pediatric Femur Fractures. J Pediatr Orthop. 2020;40(7):e560-e5.
  • 19- Gogi N, Khan SA, Varshney MK. Limb length discrepancy following titanium elastic nailing pediatric femoral shaft fractures. Acta Orthop Belg. 2006;72(2):154-8.
  • 20- Vallamshetla VR, De Silva U, Bache CE, Gibbons PJ. Flexible intramedullary nails for unstable fractures of the tibia in children. An eight-year experience. J Bone Joint Surg Br. 2006;88(4): 536-40.
  • 21- Sankar WN, Jones KJ, Horn BD, Wells L. Titanium elastic nails for pediatric tibial shaft fractures. J Child. Orthop. 2007;1(5):281–6.
  • 22- Sinikumpu JJ, Serlo W. The shaft fractures of the radius and ulna in children: current concepts. J Pediatr Orthop B. 2015;24(3):200-6.
  • 23- Kc KM, Acharya P, Sigdel A. Titanium Elastic Nailing System (TENS) for Tibia Fractures in Children: Functional Outcomes and Complications. JNMA J Nepal Med Assoc. 2016;55(204):55-60.
  • 24- Lu D, Lin Z, Zhang JD, Chen H, Sun LJ. Treatment of pediatric forearm midshaft fractures: is there a difference between types of orthopedic surgeon? Orthop Traumatol Surg Res. 2017;103(1):119–22.
  • 25- Blackman AJ, Wall LB, Keeler KA, Schoenecker L, Luhmann SJ, O’Donnell JC, et al. Acute compartment syndrome after intramedullary nailing of isolated radius and ulna fractures in children. J Pediatr Orthop. 2014;34(1):50–4.
  • 26- Flynn JM, Jones KJ, Garner MR, Goebel J. Eleven years’ experience in the operative management of pediatric forearm fractures. J Pediatr Orthop. 2010;30(4):313-9.
  • 27- Gordon JE, Gregush RV, Schoenecker PL, Dobbs MB, Luhmann SJ. Complications After Titanium Elastic Nailing of Pediatric Tibial Fractures. J Pediatr Orthop. 2007;27(4):442–6.
  • 28- Slongo TF. Complications and failures of the ESIN technique. Injury. 2005;36(1):78-85.
  • 29- Yeo JH, Jung ST, Kim MC, Yang HY. Diaphyseal Nonunion in Children. J Orthop Trauma. 2018;32(2):e52-e8.
  • 30- Kapila R, Sharma R, Chugh A, Goyal M. Evaluation of clinical outcomes of management of paediatric bone forearm fractures using titanium elastic nailing system: a prospective study of 50 cases. J Clin Diagn Res. 2016;10(11):12-5.
  • 31- Ballal MS, Garg NK, Bruce CE, Bass A. Nonunion of the ulna after elastic stable intramedullary nailing for unstable forearm fractures: a case series. J Pediatr Orthop B. 2009;18(5):261–4.
  • 32- Saikia K, Bhuyan S, Bhattacharya Td, Saikia Sp. Titanium elastic nailing in femoral diaphyseal fractures of children in 6-16 years of age. Indian J Orthop. 2007;41(4):381-5.
  • 33- Karaduman ZO. Retrospective Evaluation of the Results of Elastic Intramedullary Nailing in Pediatric Femoral, Tibial, and Forearm Diaphyseal Fractures. Middle Black Sea Journal of Health Science 2019;5(2):226-32.
  • 34- El-Adl G, Mostafa MF, Khalil MA, Enan A. Titanium elastic nail fixation for paediatric femoral and tibial fractures. Acta Orthop Belg. 2009;75(4):512–20.
  • 35- Luo Y, Wang L, Zhao LH, Wang YC, Chen MJ, Wang S, et al. Elastic Stable Titanium Flexible Intramedullary Nails Versus Plates in Treating Low-Grade Comminuted Femur Shaft Fractures in Children. Orthop Surg. 2019;11(4):664-70.
Yıl 2022, Cilt: 8 Sayı: 4, 603 - 614, 30.11.2022
https://doi.org/10.19127/mbsjohs.1148801

Öz

Kaynakça

  • 1- Omeroglu H. Basic principles of fracture treatment in children. Eklem Hastalik Cerrahisi. 2018;29(1):52-7.
  • 2- Becker T, Weigl D, Mercado E, Katz K, Bar-On E. Fractures and refractures after femoral locking compression plate fixation in children and adolescents. J Pediatr Orthop. 2012;32(7):e40-6.
  • 3- Nisar A, Bhosale A, Madan SS, Flowers MJ, Fernandes JA, Jones S. Complications of Elastic Stable Intramedullary Nailing for treating paediatric long bone fractures. J Orthop. 2013;10(1):17-24.
  • 4- Khuntia S, Swaroop S, Patro BP, Sahu S. Paediatric Long Bone Fractures Managed with Elastic Intramedullary Nails: A Retrospective Study of 30 Patients. Cureus. 2020;12(4):e7847.
  • 5- Assaghir YM. Titanium elastic nail in femur fractures as an alternative to spica cast in preschoolers. J Child Orthop. 2012;6(6):505–11.
  • 6- Sutphen SA, Mendoza JD, Mundy AC, Yang JG, Beebe AC, Samora WP 3rd, et al. Pediatric Diaphyseal Femur Fractures: Submuscular Plating Compared with Intramedullary Nailing. Orthopedics. 2016;39(6):353-8.
  • 7- Govindasamy R, Gnanasundaram R, Kasirajan S, Ibrahim S, Melepuram JS. Elastic Stable Intramedullary Nailing of Femoral Shaft Fracture-Experience in 48 Children. Arch Bone Jt Surg. 2018;6(1):39-46.
  • 8- Uludağ A, Tosun HB. Treatment of Unstable Pediatric Tibial Shaft Fractures with Titanium Elastic Nails. Medicina. 2019;55(6):266.
  • 9- Pandya NK, Edmonds EW, Mubarak SJ. The incidence of compartment syndrome after flexible nailing of pediatric tibial shaft fractures. J Child Orthop. 2011;5(6):439–47.
  • 10- Flynn JM, Hresko T, Reynolds RA, Blasier RD, Davidson R, Kasser J. Titanium elastic nails for pediatric femur fractures: a multicenter study of early results with analysis of complications. J Pediatr Orthop. 2001;21(1):4–8.
  • 11- Imam MA, Negida AS, Elgebaly A, Hussain AS, ErnstbrunnerL, Javed S, et al. Titanium elastic nails versus spica cast in pediatric femoral shaft fractures: a systematic review and meta-analysis of 1012 patients. Arch Bone Jt Surg. 2018;6(3):176-88.
  • 12- Lascombes P, Haumont T, Journeau P. Use and abuse of flexible intramedullary nailing in children and adolescents. J Pediatr Orthop. 2006;26(6):827–34.
  • 13- Cai L, Wang J, Du S, Zhu S, Wang T, Chen H. Comparison of hybrid fixation to dual plating for both-bone forearm fractures in older children. Am J Ther. 2016;23(6):e1391–e96.
  • 14- Debnath S, Debbarma S, Sarkar A. Titanium elastic nailing osteosynthesis for diaphyseal tibial fracture in pediatrıc age group-our experience. Indian J Appl Res. 2017;7(7):52–3.
  • 15- Heo J, Oh CW, Park KH, Kim JW, Kim HJ, Lee JC, et al. Elastic nailing of tibia shaft fractures in young children up to 10 years of age. Injury. 2016;47(4):832–36.
  • 16- Kawalkar A, Badole CM. Percutaneous titanium elastic nail for femoral shaft fracture in patient between 5 and 15 years. J Orthop. 2018;15(2):695-700.
  • 17- Pennock AT, Bastrom TP, Upasani VV. Elastic Intramedullary Nailing Versus Open Reduction Internal Fixation of Pediatric Tibial Shaft Fractures. J Pediatr Orthop. 2017;37(7):e403-e8.
  • 18- Siddiqui AA, Abousamra O, Compton E, Meisel E, Illingworth KD. Titanium Elastic Nails Are a Safe and Effective Treatment for Length Unstable Pediatric Femur Fractures. J Pediatr Orthop. 2020;40(7):e560-e5.
  • 19- Gogi N, Khan SA, Varshney MK. Limb length discrepancy following titanium elastic nailing pediatric femoral shaft fractures. Acta Orthop Belg. 2006;72(2):154-8.
  • 20- Vallamshetla VR, De Silva U, Bache CE, Gibbons PJ. Flexible intramedullary nails for unstable fractures of the tibia in children. An eight-year experience. J Bone Joint Surg Br. 2006;88(4): 536-40.
  • 21- Sankar WN, Jones KJ, Horn BD, Wells L. Titanium elastic nails for pediatric tibial shaft fractures. J Child. Orthop. 2007;1(5):281–6.
  • 22- Sinikumpu JJ, Serlo W. The shaft fractures of the radius and ulna in children: current concepts. J Pediatr Orthop B. 2015;24(3):200-6.
  • 23- Kc KM, Acharya P, Sigdel A. Titanium Elastic Nailing System (TENS) for Tibia Fractures in Children: Functional Outcomes and Complications. JNMA J Nepal Med Assoc. 2016;55(204):55-60.
  • 24- Lu D, Lin Z, Zhang JD, Chen H, Sun LJ. Treatment of pediatric forearm midshaft fractures: is there a difference between types of orthopedic surgeon? Orthop Traumatol Surg Res. 2017;103(1):119–22.
  • 25- Blackman AJ, Wall LB, Keeler KA, Schoenecker L, Luhmann SJ, O’Donnell JC, et al. Acute compartment syndrome after intramedullary nailing of isolated radius and ulna fractures in children. J Pediatr Orthop. 2014;34(1):50–4.
  • 26- Flynn JM, Jones KJ, Garner MR, Goebel J. Eleven years’ experience in the operative management of pediatric forearm fractures. J Pediatr Orthop. 2010;30(4):313-9.
  • 27- Gordon JE, Gregush RV, Schoenecker PL, Dobbs MB, Luhmann SJ. Complications After Titanium Elastic Nailing of Pediatric Tibial Fractures. J Pediatr Orthop. 2007;27(4):442–6.
  • 28- Slongo TF. Complications and failures of the ESIN technique. Injury. 2005;36(1):78-85.
  • 29- Yeo JH, Jung ST, Kim MC, Yang HY. Diaphyseal Nonunion in Children. J Orthop Trauma. 2018;32(2):e52-e8.
  • 30- Kapila R, Sharma R, Chugh A, Goyal M. Evaluation of clinical outcomes of management of paediatric bone forearm fractures using titanium elastic nailing system: a prospective study of 50 cases. J Clin Diagn Res. 2016;10(11):12-5.
  • 31- Ballal MS, Garg NK, Bruce CE, Bass A. Nonunion of the ulna after elastic stable intramedullary nailing for unstable forearm fractures: a case series. J Pediatr Orthop B. 2009;18(5):261–4.
  • 32- Saikia K, Bhuyan S, Bhattacharya Td, Saikia Sp. Titanium elastic nailing in femoral diaphyseal fractures of children in 6-16 years of age. Indian J Orthop. 2007;41(4):381-5.
  • 33- Karaduman ZO. Retrospective Evaluation of the Results of Elastic Intramedullary Nailing in Pediatric Femoral, Tibial, and Forearm Diaphyseal Fractures. Middle Black Sea Journal of Health Science 2019;5(2):226-32.
  • 34- El-Adl G, Mostafa MF, Khalil MA, Enan A. Titanium elastic nail fixation for paediatric femoral and tibial fractures. Acta Orthop Belg. 2009;75(4):512–20.
  • 35- Luo Y, Wang L, Zhao LH, Wang YC, Chen MJ, Wang S, et al. Elastic Stable Titanium Flexible Intramedullary Nails Versus Plates in Treating Low-Grade Comminuted Femur Shaft Fractures in Children. Orthop Surg. 2019;11(4):664-70.
Toplam 35 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Ümit Aygün 0000-0001-7234-1654

Murat Bölükbaşı 0000-0002-7022-155X

Yayımlanma Tarihi 30 Kasım 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 8 Sayı: 4

Kaynak Göster

Vancouver Aygün Ü, Bölükbaşı M. Evaluation of Radiological and Functional Results of Long Bone Diaphyseal Fractures in Children Aged 5-15 Years Who Underwent Titanium Elastic Nail. Middle Black Sea Journal of Health Science. 2022;8(4):603-14.

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