Titanium Elastic Nails Are a Safe and Effective Treatment for Length Unstable Pediatric Femur Fractures

被引:18
作者
Siddiqui, Ali A. [1 ,2 ]
Abousamra, Oussama [1 ,2 ]
Compton, Edward [1 ,2 ]
Meisel, Erin [1 ,2 ]
Illingworth, Kenneth D. [1 ,2 ]
机构
[1] Childrens Hosp Los Angeles, Childrens Orthopaed Ctr, 4650 Sunset Blvd,MS 69, Los Angeles, CA 90027 USA
[2] Univ Southern Calif, Keck Sch Med, Los Angeles, CA 90007 USA
关键词
femur fracture; titanium elastic nail; flexible intramedullary nail; length unstable; length stable; FEMORAL-SHAFT FRACTURES; COMPLICATIONS; FIXATION; CHILDREN;
D O I
10.1097/BPO.0000000000001474
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: Controversy exists regarding the treatment of length unstable pediatric femoral shaft fractures. The purpose of this study was to investigate the outcomes of skeletally immature children with length unstable femur fractures treated with titanium elastic nails (TENs). Methods: A retrospective review was conducted on all patients with femoral shaft fractures at a tertiary care pediatric hospital from April 2006 to January 2018. Patients with femoral shaft fractures treated with TEN and minimum 6 months follow-up were included. Exclusion criteria were age 11 years or above, weight >50 kg, pathologic fracture, and neuromuscular disorders. Femur fractures were categorized into 2 groups: length unstable (spiral, comminuted, or long oblique fractures) versus length stable (transverse and short oblique). Complications and reoperations were compared between the groups. Results: A total of 57 patients with 58 femoral shaft fractures were included. The mean age was 5 +/- 2 (1 to 11) years and mean follow-up was 20.4 +/- 18.1 (6.0 to 81.2) months. The mean weight was 22.9 +/- 7.7 (11.0 to 40.5) kg. There was no difference in age (P=0.32), weight (P=0.28) or follow-up length (P=0.57) between patients with length unstable fractures and those with length stable fractures. A total of 32/58 (55%) fractures were length unstable and 26/58 (45%) were length stable. Mean time to union was 4.6 months, and there was no significant difference in mean time to union between the 2 groups (P=0.71). Thirty-one complications occurred in 27 patients. There was no difference between groups in the incidence of major complications requiring revision surgery (P=0.68) and minor complications that did not require revision surgery (P>0.99). Conclusions: In children with femoral shaft fractures treated with TEN, there was no difference in the incidence of complications or reoperations between those with length unstable fractures and those with length stable fractures. TEN are a safe and effective choice for operative fixation of length unstable femoral shaft fractures in children.
引用
收藏
页码:E560 / E565
页数:6
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