Ender nail fixation of fracture shaft femur in head injured children

A study was done over twelve children suffering fracture femur and head injury had been managed using ender nails as a method of fixation, The patients had twelve fractures. The average age at the time of injuries was 7.4 years old. There were six males and six females. There were nine closed fractures and the remaining three were grad I open fracture and radiological union occurred at an average of eight weeks after operation [range six to ten weeks]. The nails were removed at an average of 7.6 months. There was average 0.75 cm lengthening at the time of last follow up. There were no reported infections, delayed union or skin complication in all twelve patients. The study showed that ender nail and safe option for children having fracture femur in the presence of head injury

Treatment of nonunion of the humerus using the Ilizarov external fixator

Sixteen patients with nonunited humeral shaft fractures were treated from January 1999 to December 2001 using the Ilizarov method of monofocal compression. 14 were males and 2 were females, their ages ranged between 22 and 55 years with a mean age of 34. All of them had at least one previous surgery, 8 cases had plate fixation, 4 cases were treated with external fixator and the other 4 cases had intramedullary fixation. Seven nonunions were hypertrophic, and 9 were atrophic. Seven cases were infected nonunion. The combined circular-semicircular modification from Cattaneo et al was used with wires and 5 mm unilateral self tapping Shanz pins. The average follow-up period was 12 months. Union was obtained in 15 cases with an average consolidation time of 4 months. Apart from superficial pin tract infection seen in most of the cases, there was no nerve injuries or other significant complications. The results show that Ilizarov method is a reliable method for the treatment of humeral nonunion, even after multiple previous surgeries or in the event of infection

Evaluation of the results of external fixation of femoral shaft fractures in children

Thirty-four patients with 35 femoral shaft fractures were treated using the AO unilateral external fixator after reductionfrom 1999 through 2000. Thirteen girls and 21 boys were the material of this study. The average patient age at presentation was 9.5 years [range 6-14 years]. There were 16 children with multiple injuries whereas 18 children had isolated femoral shaft fractures. All the fractures were followed until union, with an average time of external fixation of 75 days. The average follow-up was 1.5 years. All the fractures healed without additional surgical intervention. There was minimal angulation at the fracture site with an average of 4.5 degrees in the anteroposterior plane and 4.6 degrees in the lateral plane. Although pin tract infection was common [10 cases], nine of them resolved with a broad-spectrum oral antibiotics, only one patient required inpatient intravenous antibiotics. No patient developed osteomyelitis. 24 patients had clinically equal leg lengths, 9 patients had clinically less than 10 mm of inequality and only one patient had 15 mm discrepancy. We had no re-fractures after removal of the fixator, We agree with previous reports that external fixation remains a viable option for the treatment of femoral shaft fractures in children with multiple injuries. It is also an effective means of treating isolated femoral shaft fractures in the pediatric population