FLEXIBLE INTRAMEDULLARY NAIL FIXATION IN PEDIATRIC FEMORAL SHAFT FRACTURES

Öz

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.

Anahtar Kelimeler

• pediatric
• femur fracture
• titanium elastic nails

Kaynakça

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