Complications and problems in intramedullary nailing of children's fractures

被引：0

作者：

Schmittenbecher P.P. ^{[1
]}

Dietz H.G. ^{[2
]}

Linhart W.E. ^{[3
]}

Slongo T. ^{[4
]}

机构：

[1] Department of Pediatric Surgery, St. Hedwig's Hospital, Regensburg

[2] Department of Pediatric Surgery, Dr. von Hauner's Children's Hospital, University of Munich, Munich

[3] Department of Pediatric Orthopedics, Pediatric Surgical University Hospital, Graz

[4] Department of Surgery, University Children's Hospital, Bern

来源：

European Journal of Trauma | 2000年 / 26卷 / 6期

关键词：

Children; Complications; Elastic stable intramedullary nailing (ESIN); Fracture;

D O I：

10.1007/PL00002453

中图分类号：

学科分类号：

摘要：

Elastic stable intramedullary nailing (ESIN) is well established for stabilizing pediatric diaphyseal and special metaphyseal limb fractures. Expanding its application requires the evaluation of problems and complications to prevent uncritical use. Four pediatric surgical departments participated in a retrospective study. Between 1990 and 1998, 937 fractures were treated by ESIN. Major indications were forearm and femur fractures. Continuous documentation of treatment, postoperative course and follow-up formed the basis of evaluation. Analysis was subdivided into intraoperative problems, postoperative problems, and complications. Intraoperative problems (6.5%) were characterized by open reduction, cortical perforation by a nail tip with subsequent instability and by iatrogenic bursting of a third fragment. Postoperatively, 6.4% of patients showed soft tissue irritation due to nail ends or joint effusions. Complications (8.4%) included axial deviation > 10° or instability of osteosynthesis in 5.3% and nerve injuries in 1.4%. Delayed healing, pseudarthrosis, osteomyelitis and synostosis were only observed in isolated cases, 5 children sustained a refracture. Severe complications are rare, problems arise from suboptimal technique and incorrect indication. Detailed knowledge of technical principles and procedural recommendations constitutes the mainstay in prevention.

引用

页码：287 / 293

页数：6

共 14 条

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