Early Complications of Elastic Stable Intramedullary Nails in the Treatment of Pediatric Diaphyseal Fractures of Long Bones: an Experience in Duhok Center of Orthopedic Surgery

Authors

  • Ageed Ameer Abduljabar
  • Las Hwaizi Hwaizi
  • Laween Omar Musa

DOI:

https://doi.org/10.56056/amj.2024.237

Keywords:

Diaphyseal fractures, Elastic stable intramedullary nails, Pediatric trauma Surgical intervention

Abstract

Background and objectives: diaphyseal fractures in the pediatric age group should be perfectly treated. Treatment options are too many with long lists of pros and cons. This study aims to determine complications of elastic Table intramedullary as an evolving method in the era of operative treatment.

Methods: This is a prospective case series study, conducted at Duhok Emergency Teaching Hospital between march/2021 and April/2022. The sample size was 100 children (mean age was 6.53 years). Inclusion criteria were: diaphyseal fractures (open and closed) in children 3-12 years. Exclusion criteria were: humeral fractures, fractures of the radial neck, pathological fractures, and obese patients (>40kgs). All of them were operated on under general anesthesia and their fractures were fixed with elastic stable intramedullary nails under C-arm, follow up period was 6-9 months both clinically and radiologically.

Results: complications were found in the following order of frequency: 39.02% insertion site irritation, 14.02 joint swelling, 9.76% superficial infection, 7.93% loss of reduction, 7.32% stiffness, 3,66% delayed union, 3.05% limb length discrepancy and 0.61% deep infection. While the frequency of complications was significantly related to the type of fracture as (p-value: 0.031) and transverse fractures were seen to be associated with the highest complication rate, no significant relation was found between the frequency of complication with either age groups or gender as the (p-value: 0.447) for frequency of complications among both age groups and (0.711) between the two genders.

Conclusion: fixation with elastic stable intramedullary nails is a good choice of treatment for diaphyseal fractures in the pediatric age group however it is not free of complications.

Downloads

Download data is not yet available.

References

Buckley R, Moran C, Apivatthakakul T. AO Principles of Fracture Management. 3rd ed. Stuttgart: Thieme; 2017.

Joeris A, Lutz N, Wicki B, Slongo T, Audigé L. An epidemiological evaluation of pediatric long bone fractures — a retrospective cohort study of 2716 patients from two Swiss tertiary pediatric hospitals. BMC Pediatrics. 2014; 14(1).

Waters P, Skaggs D, Flynn J. Rockwood and Wilkins' Fractures in Children. 9th ed. Philadelphia: Wolters Kluwer Health; 2014.

Furlan D, Pogoreli? Z, Bio?i? M, et al. Elastic STable Intramedullary Nailing for Pediatric Long Bone Fractures: Experience with 175 Fractures. Scand J Surg. 2011; 100(3):208-15.

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.

Osateerakun P, Limpaphayom N. Elastic STable Intramedullary Nail: The Viable Technique for Pediatric Long Bone Fixation. J Sea Ortho. 2014; 38(1):31-7.

Abosala A, Westacott D, Cunningham J. A Biomechanical Study of the Stability of Titanium Elastic Nails in the Treatment of Oblique Segmental Fracture of the Femur in Children. Internet J Orthop Surg. 2010; 19(1):1-8.

Pulate A, Jadhav A, Shah BN. Study of the Outcome of Titanium Elastic Nail System in Diaphyseal Femoral Fractures in Children. J Maharashtra Orthop Assoc. 2012; 7:6-8.

Vopat ML, Kane PM, Christino MA, Truntzer J, McClure P, Katarincic J, et al. Treatment of Diaphyseal Forearm Fractures in Children. Orthop Rev. 2014; 6(2):5325. Fernandez F, Langendörfer M, Wirth T, Eberhardt O. Failures and complications in intramedullary nailing of children's forearm fractures. J Child Orthop. 2010; 4(2): 159-67.

Amin A, Nahla A, Gaber A, Kamsawi M. Elastic STable Intramedullary Nailing Femoral Shaft Fractures in Children from Six to Ten Years Age. Egypt J Hosp Med. 2021; 84:1908-13.

Khanna M, Wadhwani J, Batra A, Yadav S, Iman S, Vashishth S. TENS for the surgical management of femoral shaft fractures in 6-14 years age group children. Pediatr Traum Orthop Reconstr Surg. 2017; 5(2):13-21.

Sarkar S, Bandyopadhyay R, Mukherjee A. Titanium Elastic Nail - Complications in the Treatment of Paediatric Diaphyseal Fracture of Femur. Open J Orthop. 2013; 7:12–7

Kc KM, Acharya P, Sigdel A. Titanium Elastic Nailing System (TENS) for Tibia Fractures in Children: Functional Outcomes and Complications. J Nepal Med Assoc. 2016; 55(204):55-60.

KM, Acharya P, Sigdel A. Titanium Elastic Nailing System (TENS) for Tibia Fractures in Children: Functional Outcomes and Complications. J Nepal Med Assoc. 2016;55(204):55-60. https://pubmed.ncbi.nlm.nih.gov/28029668/

Downloads

Published

2024-03-10

How to Cite

Abduljabar, A. A. ., Hwaizi, L. H., & Musa, L. O. (2024). Early Complications of Elastic Stable Intramedullary Nails in the Treatment of Pediatric Diaphyseal Fractures of Long Bones: an Experience in Duhok Center of Orthopedic Surgery. AMJ (Advanced Medical Journal) , 9(1), 56-67. https://doi.org/10.56056/amj.2024.237

Issue

Section

Articles