ABSTRACT
PURPOSE: To demonstrate the effectiveness of intramedullary fixation of displaced long bones shaft fractures in skeletally immature children using the elastic stable intramedullary nails. PATIENTS AND METHODS: The case records of 173 children who underwent fixation with titanium intramedulary nails because of long bones fractures were reviewed. The average age of the patients was 11.7 years, and mean follow-up was 41.3 months. There were 55 humeral, 42 forearm, 42 femoral and 36 tibial fractures. Subjective satisfaction was assessed. RESULTS: All patients achieved complete healing at a mean of 7.5 weeks. Complications were recorded in 11 (6.3%) patients and included: one neuropraxia, six entry site skin irritations, two protrusions of the wires through the skin and two skin infections at the entry site. In a subjective measure of outcome at follow-up, 89% of patients were very satisï¬ed and 11% satisï¬ed; no patients reported their outcome as not satisï¬ed. The implants were removed at a median time of six months from the index operation. CONCLUSION: Elastic Stable Intra-medullary Nailing is the method of choice for the pediatrics patients, because it is minimaly invasive and shows very good functional and cosmetic results. It allows an early functional and cast-free follow-up with a quick pain reduction.
Subject(s)
Bone Nails , Femoral Fractures/surgery , Fracture Fixation, Intramedullary/instrumentation , Humeral Fractures/surgery , Radius Fractures/surgery , Tibial Fractures/surgery , Adolescent , Child , Child, Preschool , Female , Femoral Fractures/diagnostic imaging , Fracture Healing , Humans , Humeral Fractures/diagnostic imaging , Male , Pain Measurement , Postoperative Complications , Radiography , Radius Fractures/diagnostic imaging , Tibial Fractures/diagnostic imaging , Titanium , Treatment OutcomeABSTRACT
Heterotopic ossification is defined as the formation of mature, lamellar bone within soft tissues other than the periosteum. We present a case of a 9-year-old girl with formation of heterotopic bone tissue in the elbow after surgical treatment of a fracture of the lateral humeral condyle. Eight months after the first operation the girl was re-operated to resect the heterotopic bone tissue. We believe that radical surgical excision of heterotopic bone, following physiotherapy around the elbow in children can improve the function of the extremity.
