Failures and complications in intramedullary nailing of children’s forearm fractures
Purpose There are published studies of outcomes in the use of ESIN that raise concerns about serious complications: the aim of this study is to report our experiences over 17 years of use of this technique, which shows that complications and failures are insignificant when the method is applied corr...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Fernandez, F. F. [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2010 |
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| Schlagwörter: |
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| Anmerkung: |
© EPOS 2010 |
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| Übergeordnetes Werk: |
Enthalten in: Journal of children's orthopaedics - London : Sage, 2007, 4(2010), 2 vom: 24. Feb., Seite 159-167 |
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| Übergeordnetes Werk: |
volume:4 ; year:2010 ; number:2 ; day:24 ; month:02 ; pages:159-167 |
| Links: |
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| DOI / URN: |
10.1007/s11832-010-0245-y |
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SPR022617299 |
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| 245 | 1 | 0 | |a Failures and complications in intramedullary nailing of children’s forearm fractures |
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| 520 | |a Purpose There are published studies of outcomes in the use of ESIN that raise concerns about serious complications: the aim of this study is to report our experiences over 17 years of use of this technique, which shows that complications and failures are insignificant when the method is applied correctly. Method We present a retrospective analysis of 553 children with forearm shaft fractures treated with elastic stable intramedullary nailing over a period of 17 years. The 354 boys (64%) and 199 girls (36%) had an average age of 9.1 years. A total of 61% of the fractures were located in the midshaft, 21% in the distal diaphyseal and 18% in the proximal third. Continuous documentation of treatment, postoperative course and follow-up after an average time of 37 months formed the basis of this study. The analysis included all kinds of failures and complications. Results The following complications and problems were encountered: 5 children with wound infections and disturbed wound healing, 1 case of osteomyelitis, 7 children with ulnar non-unions, 14 children with delayed unions, 6 cases of loss of correction, 15 children with lesions of the superficial radial nerve, one case of malplacement of a nail, 5 children with skin perforations caused by the ends of implants and 27 children with refractures. Conclusion The analysis of the failures and complications shows that a differentiated approach to the data has to be taken. Most complications occur because of incorrect use of the method with neglect of biomechanical principles. The usage of the ESIN method is extended to more problematic regions, such as the distal diaphyseal portion of the forearm, and therefore, an increase in complications is likely. Despite this risk, ESIN should still be the standard treatment for forearm shaft fractures in children, and no change in therapeutical strategy is necessary. However, it is of special importance to follow the right indication and to pay attention to biomechanical principles and to correct technical procedure. | ||
| 650 | 4 | |a Elastic stable intramedullary nailing |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Children |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Complications |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Forearm fracture |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Langendörfer, M. |4 aut | |
| 700 | 1 | |a Wirth, T. |4 aut | |
| 700 | 1 | |a Eberhardt, O. |4 aut | |
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10.1007/s11832-010-0245-y doi (DE-627)SPR022617299 (SPR)s11832-010-0245-y-e DE-627 ger DE-627 rakwb eng Fernandez, F. F. verfasserin aut Failures and complications in intramedullary nailing of children’s forearm fractures 2010 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © EPOS 2010 Purpose There are published studies of outcomes in the use of ESIN that raise concerns about serious complications: the aim of this study is to report our experiences over 17 years of use of this technique, which shows that complications and failures are insignificant when the method is applied correctly. Method We present a retrospective analysis of 553 children with forearm shaft fractures treated with elastic stable intramedullary nailing over a period of 17 years. The 354 boys (64%) and 199 girls (36%) had an average age of 9.1 years. A total of 61% of the fractures were located in the midshaft, 21% in the distal diaphyseal and 18% in the proximal third. Continuous documentation of treatment, postoperative course and follow-up after an average time of 37 months formed the basis of this study. The analysis included all kinds of failures and complications. Results The following complications and problems were encountered: 5 children with wound infections and disturbed wound healing, 1 case of osteomyelitis, 7 children with ulnar non-unions, 14 children with delayed unions, 6 cases of loss of correction, 15 children with lesions of the superficial radial nerve, one case of malplacement of a nail, 5 children with skin perforations caused by the ends of implants and 27 children with refractures. Conclusion The analysis of the failures and complications shows that a differentiated approach to the data has to be taken. Most complications occur because of incorrect use of the method with neglect of biomechanical principles. The usage of the ESIN method is extended to more problematic regions, such as the distal diaphyseal portion of the forearm, and therefore, an increase in complications is likely. Despite this risk, ESIN should still be the standard treatment for forearm shaft fractures in children, and no change in therapeutical strategy is necessary. However, it is of special importance to follow the right indication and to pay attention to biomechanical principles and to correct technical procedure. Elastic stable intramedullary nailing (dpeaa)DE-He213 Children (dpeaa)DE-He213 Complications (dpeaa)DE-He213 Forearm fracture (dpeaa)DE-He213 Langendörfer, M. aut Wirth, T. aut Eberhardt, O. aut Enthalten in Journal of children's orthopaedics London : Sage, 2007 4(2010), 2 vom: 24. Feb., Seite 159-167 (DE-627)523858221 (DE-600)2268264-8 1863-2548 nnns volume:4 year:2010 number:2 day:24 month:02 pages:159-167 https://dx.doi.org/10.1007/s11832-010-0245-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2006 GBV_ILN_2010 GBV_ILN_2014 GBV_ILN_2018 GBV_ILN_2020 GBV_ILN_2057 GBV_ILN_2190 GBV_ILN_2707 GBV_ILN_2890 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 4 2010 2 24 02 159-167 |
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10.1007/s11832-010-0245-y doi (DE-627)SPR022617299 (SPR)s11832-010-0245-y-e DE-627 ger DE-627 rakwb eng Fernandez, F. F. verfasserin aut Failures and complications in intramedullary nailing of children’s forearm fractures 2010 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © EPOS 2010 Purpose There are published studies of outcomes in the use of ESIN that raise concerns about serious complications: the aim of this study is to report our experiences over 17 years of use of this technique, which shows that complications and failures are insignificant when the method is applied correctly. Method We present a retrospective analysis of 553 children with forearm shaft fractures treated with elastic stable intramedullary nailing over a period of 17 years. The 354 boys (64%) and 199 girls (36%) had an average age of 9.1 years. A total of 61% of the fractures were located in the midshaft, 21% in the distal diaphyseal and 18% in the proximal third. Continuous documentation of treatment, postoperative course and follow-up after an average time of 37 months formed the basis of this study. The analysis included all kinds of failures and complications. Results The following complications and problems were encountered: 5 children with wound infections and disturbed wound healing, 1 case of osteomyelitis, 7 children with ulnar non-unions, 14 children with delayed unions, 6 cases of loss of correction, 15 children with lesions of the superficial radial nerve, one case of malplacement of a nail, 5 children with skin perforations caused by the ends of implants and 27 children with refractures. Conclusion The analysis of the failures and complications shows that a differentiated approach to the data has to be taken. Most complications occur because of incorrect use of the method with neglect of biomechanical principles. The usage of the ESIN method is extended to more problematic regions, such as the distal diaphyseal portion of the forearm, and therefore, an increase in complications is likely. Despite this risk, ESIN should still be the standard treatment for forearm shaft fractures in children, and no change in therapeutical strategy is necessary. However, it is of special importance to follow the right indication and to pay attention to biomechanical principles and to correct technical procedure. Elastic stable intramedullary nailing (dpeaa)DE-He213 Children (dpeaa)DE-He213 Complications (dpeaa)DE-He213 Forearm fracture (dpeaa)DE-He213 Langendörfer, M. aut Wirth, T. aut Eberhardt, O. aut Enthalten in Journal of children's orthopaedics London : Sage, 2007 4(2010), 2 vom: 24. Feb., Seite 159-167 (DE-627)523858221 (DE-600)2268264-8 1863-2548 nnns volume:4 year:2010 number:2 day:24 month:02 pages:159-167 https://dx.doi.org/10.1007/s11832-010-0245-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2006 GBV_ILN_2010 GBV_ILN_2014 GBV_ILN_2018 GBV_ILN_2020 GBV_ILN_2057 GBV_ILN_2190 GBV_ILN_2707 GBV_ILN_2890 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 4 2010 2 24 02 159-167 |
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10.1007/s11832-010-0245-y doi (DE-627)SPR022617299 (SPR)s11832-010-0245-y-e DE-627 ger DE-627 rakwb eng Fernandez, F. F. verfasserin aut Failures and complications in intramedullary nailing of children’s forearm fractures 2010 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © EPOS 2010 Purpose There are published studies of outcomes in the use of ESIN that raise concerns about serious complications: the aim of this study is to report our experiences over 17 years of use of this technique, which shows that complications and failures are insignificant when the method is applied correctly. Method We present a retrospective analysis of 553 children with forearm shaft fractures treated with elastic stable intramedullary nailing over a period of 17 years. The 354 boys (64%) and 199 girls (36%) had an average age of 9.1 years. A total of 61% of the fractures were located in the midshaft, 21% in the distal diaphyseal and 18% in the proximal third. Continuous documentation of treatment, postoperative course and follow-up after an average time of 37 months formed the basis of this study. The analysis included all kinds of failures and complications. Results The following complications and problems were encountered: 5 children with wound infections and disturbed wound healing, 1 case of osteomyelitis, 7 children with ulnar non-unions, 14 children with delayed unions, 6 cases of loss of correction, 15 children with lesions of the superficial radial nerve, one case of malplacement of a nail, 5 children with skin perforations caused by the ends of implants and 27 children with refractures. Conclusion The analysis of the failures and complications shows that a differentiated approach to the data has to be taken. Most complications occur because of incorrect use of the method with neglect of biomechanical principles. The usage of the ESIN method is extended to more problematic regions, such as the distal diaphyseal portion of the forearm, and therefore, an increase in complications is likely. Despite this risk, ESIN should still be the standard treatment for forearm shaft fractures in children, and no change in therapeutical strategy is necessary. However, it is of special importance to follow the right indication and to pay attention to biomechanical principles and to correct technical procedure. Elastic stable intramedullary nailing (dpeaa)DE-He213 Children (dpeaa)DE-He213 Complications (dpeaa)DE-He213 Forearm fracture (dpeaa)DE-He213 Langendörfer, M. aut Wirth, T. aut Eberhardt, O. aut Enthalten in Journal of children's orthopaedics London : Sage, 2007 4(2010), 2 vom: 24. Feb., Seite 159-167 (DE-627)523858221 (DE-600)2268264-8 1863-2548 nnns volume:4 year:2010 number:2 day:24 month:02 pages:159-167 https://dx.doi.org/10.1007/s11832-010-0245-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2006 GBV_ILN_2010 GBV_ILN_2014 GBV_ILN_2018 GBV_ILN_2020 GBV_ILN_2057 GBV_ILN_2190 GBV_ILN_2707 GBV_ILN_2890 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 4 2010 2 24 02 159-167 |
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10.1007/s11832-010-0245-y doi (DE-627)SPR022617299 (SPR)s11832-010-0245-y-e DE-627 ger DE-627 rakwb eng Fernandez, F. F. verfasserin aut Failures and complications in intramedullary nailing of children’s forearm fractures 2010 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © EPOS 2010 Purpose There are published studies of outcomes in the use of ESIN that raise concerns about serious complications: the aim of this study is to report our experiences over 17 years of use of this technique, which shows that complications and failures are insignificant when the method is applied correctly. Method We present a retrospective analysis of 553 children with forearm shaft fractures treated with elastic stable intramedullary nailing over a period of 17 years. The 354 boys (64%) and 199 girls (36%) had an average age of 9.1 years. A total of 61% of the fractures were located in the midshaft, 21% in the distal diaphyseal and 18% in the proximal third. Continuous documentation of treatment, postoperative course and follow-up after an average time of 37 months formed the basis of this study. The analysis included all kinds of failures and complications. Results The following complications and problems were encountered: 5 children with wound infections and disturbed wound healing, 1 case of osteomyelitis, 7 children with ulnar non-unions, 14 children with delayed unions, 6 cases of loss of correction, 15 children with lesions of the superficial radial nerve, one case of malplacement of a nail, 5 children with skin perforations caused by the ends of implants and 27 children with refractures. Conclusion The analysis of the failures and complications shows that a differentiated approach to the data has to be taken. Most complications occur because of incorrect use of the method with neglect of biomechanical principles. The usage of the ESIN method is extended to more problematic regions, such as the distal diaphyseal portion of the forearm, and therefore, an increase in complications is likely. Despite this risk, ESIN should still be the standard treatment for forearm shaft fractures in children, and no change in therapeutical strategy is necessary. However, it is of special importance to follow the right indication and to pay attention to biomechanical principles and to correct technical procedure. Elastic stable intramedullary nailing (dpeaa)DE-He213 Children (dpeaa)DE-He213 Complications (dpeaa)DE-He213 Forearm fracture (dpeaa)DE-He213 Langendörfer, M. aut Wirth, T. aut Eberhardt, O. aut Enthalten in Journal of children's orthopaedics London : Sage, 2007 4(2010), 2 vom: 24. Feb., Seite 159-167 (DE-627)523858221 (DE-600)2268264-8 1863-2548 nnns volume:4 year:2010 number:2 day:24 month:02 pages:159-167 https://dx.doi.org/10.1007/s11832-010-0245-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2006 GBV_ILN_2010 GBV_ILN_2014 GBV_ILN_2018 GBV_ILN_2020 GBV_ILN_2057 GBV_ILN_2190 GBV_ILN_2707 GBV_ILN_2890 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 4 2010 2 24 02 159-167 |
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10.1007/s11832-010-0245-y doi (DE-627)SPR022617299 (SPR)s11832-010-0245-y-e DE-627 ger DE-627 rakwb eng Fernandez, F. F. verfasserin aut Failures and complications in intramedullary nailing of children’s forearm fractures 2010 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © EPOS 2010 Purpose There are published studies of outcomes in the use of ESIN that raise concerns about serious complications: the aim of this study is to report our experiences over 17 years of use of this technique, which shows that complications and failures are insignificant when the method is applied correctly. Method We present a retrospective analysis of 553 children with forearm shaft fractures treated with elastic stable intramedullary nailing over a period of 17 years. The 354 boys (64%) and 199 girls (36%) had an average age of 9.1 years. A total of 61% of the fractures were located in the midshaft, 21% in the distal diaphyseal and 18% in the proximal third. Continuous documentation of treatment, postoperative course and follow-up after an average time of 37 months formed the basis of this study. The analysis included all kinds of failures and complications. Results The following complications and problems were encountered: 5 children with wound infections and disturbed wound healing, 1 case of osteomyelitis, 7 children with ulnar non-unions, 14 children with delayed unions, 6 cases of loss of correction, 15 children with lesions of the superficial radial nerve, one case of malplacement of a nail, 5 children with skin perforations caused by the ends of implants and 27 children with refractures. Conclusion The analysis of the failures and complications shows that a differentiated approach to the data has to be taken. Most complications occur because of incorrect use of the method with neglect of biomechanical principles. The usage of the ESIN method is extended to more problematic regions, such as the distal diaphyseal portion of the forearm, and therefore, an increase in complications is likely. Despite this risk, ESIN should still be the standard treatment for forearm shaft fractures in children, and no change in therapeutical strategy is necessary. However, it is of special importance to follow the right indication and to pay attention to biomechanical principles and to correct technical procedure. Elastic stable intramedullary nailing (dpeaa)DE-He213 Children (dpeaa)DE-He213 Complications (dpeaa)DE-He213 Forearm fracture (dpeaa)DE-He213 Langendörfer, M. aut Wirth, T. aut Eberhardt, O. aut Enthalten in Journal of children's orthopaedics London : Sage, 2007 4(2010), 2 vom: 24. Feb., Seite 159-167 (DE-627)523858221 (DE-600)2268264-8 1863-2548 nnns volume:4 year:2010 number:2 day:24 month:02 pages:159-167 https://dx.doi.org/10.1007/s11832-010-0245-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2006 GBV_ILN_2010 GBV_ILN_2014 GBV_ILN_2018 GBV_ILN_2020 GBV_ILN_2057 GBV_ILN_2190 GBV_ILN_2707 GBV_ILN_2890 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 4 2010 2 24 02 159-167 |
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Failures and complications in intramedullary nailing of children’s forearm fractures |
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Purpose There are published studies of outcomes in the use of ESIN that raise concerns about serious complications: the aim of this study is to report our experiences over 17 years of use of this technique, which shows that complications and failures are insignificant when the method is applied correctly. Method We present a retrospective analysis of 553 children with forearm shaft fractures treated with elastic stable intramedullary nailing over a period of 17 years. The 354 boys (64%) and 199 girls (36%) had an average age of 9.1 years. A total of 61% of the fractures were located in the midshaft, 21% in the distal diaphyseal and 18% in the proximal third. Continuous documentation of treatment, postoperative course and follow-up after an average time of 37 months formed the basis of this study. The analysis included all kinds of failures and complications. Results The following complications and problems were encountered: 5 children with wound infections and disturbed wound healing, 1 case of osteomyelitis, 7 children with ulnar non-unions, 14 children with delayed unions, 6 cases of loss of correction, 15 children with lesions of the superficial radial nerve, one case of malplacement of a nail, 5 children with skin perforations caused by the ends of implants and 27 children with refractures. Conclusion The analysis of the failures and complications shows that a differentiated approach to the data has to be taken. Most complications occur because of incorrect use of the method with neglect of biomechanical principles. The usage of the ESIN method is extended to more problematic regions, such as the distal diaphyseal portion of the forearm, and therefore, an increase in complications is likely. Despite this risk, ESIN should still be the standard treatment for forearm shaft fractures in children, and no change in therapeutical strategy is necessary. However, it is of special importance to follow the right indication and to pay attention to biomechanical principles and to correct technical procedure. © EPOS 2010 |
| abstractGer |
Purpose There are published studies of outcomes in the use of ESIN that raise concerns about serious complications: the aim of this study is to report our experiences over 17 years of use of this technique, which shows that complications and failures are insignificant when the method is applied correctly. Method We present a retrospective analysis of 553 children with forearm shaft fractures treated with elastic stable intramedullary nailing over a period of 17 years. The 354 boys (64%) and 199 girls (36%) had an average age of 9.1 years. A total of 61% of the fractures were located in the midshaft, 21% in the distal diaphyseal and 18% in the proximal third. Continuous documentation of treatment, postoperative course and follow-up after an average time of 37 months formed the basis of this study. The analysis included all kinds of failures and complications. Results The following complications and problems were encountered: 5 children with wound infections and disturbed wound healing, 1 case of osteomyelitis, 7 children with ulnar non-unions, 14 children with delayed unions, 6 cases of loss of correction, 15 children with lesions of the superficial radial nerve, one case of malplacement of a nail, 5 children with skin perforations caused by the ends of implants and 27 children with refractures. Conclusion The analysis of the failures and complications shows that a differentiated approach to the data has to be taken. Most complications occur because of incorrect use of the method with neglect of biomechanical principles. The usage of the ESIN method is extended to more problematic regions, such as the distal diaphyseal portion of the forearm, and therefore, an increase in complications is likely. Despite this risk, ESIN should still be the standard treatment for forearm shaft fractures in children, and no change in therapeutical strategy is necessary. However, it is of special importance to follow the right indication and to pay attention to biomechanical principles and to correct technical procedure. © EPOS 2010 |
| abstract_unstemmed |
Purpose There are published studies of outcomes in the use of ESIN that raise concerns about serious complications: the aim of this study is to report our experiences over 17 years of use of this technique, which shows that complications and failures are insignificant when the method is applied correctly. Method We present a retrospective analysis of 553 children with forearm shaft fractures treated with elastic stable intramedullary nailing over a period of 17 years. The 354 boys (64%) and 199 girls (36%) had an average age of 9.1 years. A total of 61% of the fractures were located in the midshaft, 21% in the distal diaphyseal and 18% in the proximal third. Continuous documentation of treatment, postoperative course and follow-up after an average time of 37 months formed the basis of this study. The analysis included all kinds of failures and complications. Results The following complications and problems were encountered: 5 children with wound infections and disturbed wound healing, 1 case of osteomyelitis, 7 children with ulnar non-unions, 14 children with delayed unions, 6 cases of loss of correction, 15 children with lesions of the superficial radial nerve, one case of malplacement of a nail, 5 children with skin perforations caused by the ends of implants and 27 children with refractures. Conclusion The analysis of the failures and complications shows that a differentiated approach to the data has to be taken. Most complications occur because of incorrect use of the method with neglect of biomechanical principles. The usage of the ESIN method is extended to more problematic regions, such as the distal diaphyseal portion of the forearm, and therefore, an increase in complications is likely. Despite this risk, ESIN should still be the standard treatment for forearm shaft fractures in children, and no change in therapeutical strategy is necessary. However, it is of special importance to follow the right indication and to pay attention to biomechanical principles and to correct technical procedure. © EPOS 2010 |
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Failures and complications in intramedullary nailing of children’s forearm fractures |
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