Functional Outcome of Shaft of Femur Fracture Fixation with Elastic Nail in Children Between 05 to 10 Years of Age
DOI:
https://doi.org/10.47489/szmc.v38i1.398Keywords:
fistula, genitourinary, surgical outcome, vesico-vaginal, iatrogenic fistulaAbstract
Introduction: Femoral fractures are one of the most common issues in the childrens population. Between 6-16 age, there's no strong agreement as to the favored therapy. The therapy of femoral fractures in children has progressively changed towards a more operative tactic within the past two decades. This is because healthcare criteria demand more rapid mobilisation , early discharge and return to family with normal activity. Operative treatment results in short hospitalization and early mobilization, which has psychological, social, educational and economic advantages over conservative treatment.
Aims & Objectives: The aim of our study is to determine the frequency of functional outcome with Flynn’s criteria in shaft of femur fracture stabilization with elastic nails in pediatric population between 5 to 10 years of age presenting in a tertiary care hospital.
Place and Duration of Study: We conducted ‘Descriptive case series’, in the unit of Orthopedic Surgery, Services Hospital, Lahore from 01-09-2021 to 01-03-2022.
Material & Methods: Sixty patients ranging from 5-10 yrs of age, fulfilling the selection criteria were enrolled after the informed consent in the study through the emergency of the Department of Orthopedic Surgery, Services Hospital, Lahore. Surgery for femoral fracture was performed in these patients under general anesthesia by a single surgical team with the assistance of the researcher. The children were followed up at 1, 2, 3, and 6 months. After 6 months, patients were evaluated according to Flynn’s criteria for femoral fracture outcomes with nailing and results were noted as excellent, satisfactory and poor. All the information was recorded in proforma. Data was entered and analyzed using SPSS version. 25.P-value ?0.05 was taken as significant.
Results: Out of 60 patients, 23.3 % ( n=14) were in age group of 5-7 years and 76.7 %( n=46) were in age group of 8- 10years and mean age was 8.17±1.01years. 65.0 %( n=39) were male and 35.0 %( n=21) were females. Out of 60 patients, 21.7 % ( n=13) had road traffic accident, 63.3 %( n=38) had history of fall and 15.0 %( n=9) had miscellaneous cause of injury. The frequency of functional outcome according to flynn’s criteria was excellent in 51.7 %( n=31).
Conclusion: We concluded that elastic nail is moderately simple to utilize and an compelling treatment for fractures of femoral shaft in legitimately chosen children by applying Flynn's criteria for functional outcome and can further be compared with other treatment modalities.
References
Khan JA, Singh GP, Pandey A. Outcome of Titanium Elastic Intramedullary Nail in the Treatment of Shaft of Femur Fracture in Children. Kathmandu Univ Med J 2015;51(3):195-9.
Chaudhary NA, Azeem M, Ahmed MS, Bilal M. Outcome of Elastic Intramedullary Nailing for the Treatment of Paediatric Femoral Shaft Fractures. Journal of Pakistan Orthopaedic Association 2018;30(4):175-8.
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-e.
Kayaokay K, Aktuglu K. Titanium elastic nailing in pediatric femoral diaphyseal fractures in the age group of 6-15 years mid-term and long-term outcomes. Pak J Med Sci 2018 Nov-Dec;34(6):1529- 33.
Parekh MN. Treatment of Paediatric Femoral Shaft Fracture with Flexible Intramedullary Nail. Journal of Surgery Pakistan 2020;25(1):13-7.
Govindasamy R, Gnanasundaram R, Kasirajan S, Ibrahim S, Melepuram JJ. Elastic Stable Intramedullary Nailing of Femoral Shaft Fracture- Experience in 48 Children. Arch Bone Jt Surg 2018;6(1):39-46.
Mahar SA, Abbasi MK, Bhayo A, Chandio MS, Palh HB, Bhatti SH. Functional Outcome of Intramedullary Fixation with Titanium Elastic Nails in Diaphyseal Fractures of Femur in Children. PJMHS 2020;14(2):610-2.
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.
Strohm PC, Schmittenbecher PP. FemurschaftfrakturenbeiKindernunter 3 Jahren: AktuellerBehandlungsstandard. Unfallchirurg. 2015;118(1):48–52.
Kapil Mani KC, Dirgha Raj RC, Parimal A. ediatric femoral shaft fractures treated by flexible intramedullary nailing. Chin J Traumatol. 2015;18(5):284–7.
Khazzam M, Tassone C, Liu XC, Lyon R, Freeto B, Schwab J, et al. Use of flexible intramedullary nail fixation in treating femur fractures in children. Am J Orthop (Belle Mead NJ) 2009;38(3):E49–55.
Saikia K, Bhuyan S, Bhattacharya T, Saikia S. Titanium elastic nailing in femoral diaphyseal fractures of children in 6 - 16 years of age. Indian J Orthop. 2007;41(4):381–5.
Santosha, Gulrez S. Titanium elastic nailing for paediatric femoral shaft fractures: a prospective descriptive study. Int J Res Orthop. 2017;3:501-07.
Kocher MS, Sink EL, Blasier RD, et al.: Treatment of pediatric diaphyseal femur fractures. J Am AcadOrthop Surg. 2009, 17:718-25. 10.5435/00124635-200911000-00006
Bahinipati J, Mohapatra RA. Observational study on titanium elastic nailing in femoral shaft fractures in children. International Journal of Research in Orthopaedics. 2019;5(1):32.
Anastasopoulos J, Petratos D, Konstantoulakis C, Plakogiannis C, Matsinos G. Flexible intramedullary nailing in pediatric femoral shaft fractures. Injury. 2010;41(6):578–82.
Brnjoš K, Lyons DK, Hyman MJ, Patel NM. Spica casting results in more unplanned reoperations than elastic intramedullary nailing: a national analysis of femur fractures in the preschool population. J Am AcadOrthop Surg Glob Res Rev. 2020;4(10):e20.00169.
Basant Titanium elastic nailing in pediatric femoral diaphyseal fractures in the age group of 5-16 years. A short term study. J Clin Ortho Trauma. 2014;5:203–210.
Abbott MD, Loder RT, Anglen JO: Comparison of submuscular and open plating of pediatric femur fractures: a retrospective review. J PediatrOrthop. 2013, 33:519-23. 10.1097/BPO.0b013e318287056d.
Valaikaite R, Tabard-Fougre A, Steiger C, Samara E, Dayer R, Ceroni D. A retrospective epidemiological study of paediatric femoral fractures. Swiss Med Wkly. 2020.
Keeler KA, Dart B, Luhmann SJ, Perry L Schoenecker, Madeleine R Ortman, Matthew B Dobbs, et al. Antegrade intramedullary nailing of pediatric femoral fractures using an interlocking pediatric femoral nail and a lateral trochanteric entry point. J PediatrOrthop. 2009;29(4):345-51.
Knedel M, Gallego EW, Gerardi J, Husak L, Altebarmakian M: Preliminary report: pediatric femur fractures: single incision intramedullary stabilization technique. J PediatrOrthop. 2015, 35:657-60.
Kong H, Sabharwal S. External fixation for closed pediatric femoral shaft fractures: where are we now? Clin OrthopRelat Res. 2014;472(12):3814–22
Cage JM, Black SR, Wimberly RL, Cook JB, Gheen WT, Jo C, Riccio AI: Two techniques for retrograde flexible intramedullary fixation of pediatric femur fractures: all-lateral entry versus medial and lateral entry point. J PediatrOrthop. 2017, 37:299-304
Stijn C, Victor A.Current practices in the management of closed femoral shaft fractures in children: A nationwide survey among Dutch orthopaedic surgeons. J of Orthopedic. 2023; 45: 1-5
Sinha SK, Kumar V, Singh A. Outcomes of fracture shaft femur in pediatric population managed at emergency. J Clin Orthop Trauma. 2017 Oct- Dec;8(4):313-319
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Proceedings
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a 