Surgical treatment of femoral diaphyseal fractures in children using elastic stable intramedullary nailing by open reduction at Yopougon Teaching Hospital

Surgical treatment of femoral diaphyseal fractures in children using elastic stable intramedullary nailing by open reduction at Yopougon Teaching Hospital

Abstract Introduction Elastic stable intramedullary nailing (ESIN) has transformed children's femoral shaft fracture treatment, but this technique requires an image intensifier. Without it, open reduction is used to check fracture reduction and pin passage. The aim of this study was to describe...

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Published in:Orthopaedics & traumatology, surgery & research Vol. 101; no. 5; pp. 589 - 592
Main Authors: Yaokreh, J.B, Odéhouri-Koudou, T.H, Koffi, K.M, Sounkere, M, Kouamé, Y.G.S, Tembely, S, Kouamé, D.B, Ouattara, O, Dick, K.R
Format: Journal Article
Language:English
Published: France Elsevier Masson SAS 01-09-2015
Subjects:
Child
Children
Cote d'Ivoire
Developing Countries
Elastic stable intramedullary nailing
Female
Femoral Fractures - surgery
Femoral shaft fractures
Fracture Fixation, Intramedullary - methods
Hospitals, Teaching
Humans
Male
Orthopedics
Postoperative Complications
Retrospective Studies
Surgery
Cote d'Ivoire
Elastic stable intramedullary nailing
Femoral shaft fractures
Children
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Summary:Abstract Introduction Elastic stable intramedullary nailing (ESIN) has transformed children's femoral shaft fracture treatment, but this technique requires an image intensifier. Without it, open reduction is used to check fracture reduction and pin passage. The aim of this study was to describe our techniques and to evaluate our results at the middle term. Hypothesis The open reduction and ESIN technique provides satisfactory results with few major complications. Patients and methods This was a retrospective study that focused on femoral diaphyseal fractures treated in the pediatric surgery unit at Yopougon Teaching Hospital (Abidjan, Côte d’Ivoire) between January 2007 and December 2013. Twenty children older than 6 years of age who underwent open reduction and ESIN without image intensifier assistance were included. Functional outcomes were assessed using Flynn's criteria. Postoperative complications and sequelae were recorded. Results At the 16-month follow-up, the results were excellent in 11 (55%) cases, good in eight (40%), and poor in one (5%) case. The mean duration of surgery was 71 min (range, 57–103 min). The mean time for bone healing was 11.6 weeks (range, 7–15 weeks) and the average time to nail removal was 6 months. Complications included wood infection ( n = 3), skin irritation ( n = 3), knee stiffness ( n = 2), malunion ( n = 3), scar ( n = 5), and leg length discrepancy ( n = 3). Discussion Open reduction and ESIN yielded satisfactory results with few major complications. This method could be an alternative in low-income countries where the image intensifier is often unavailable. Level of evidence Level IV retrospective study.
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ISSN:1877-0568
1877-0568
DOI:10.1016/j.otsr.2015.05.006