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

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


JournalOrthopaedics & traumatology, surgery & research : OTSR
Publication date – Sep – 2015
Authors – J.B.Yaokreh, T.H.Odéhouri-Koudou, K.M.Koffi, M.Sounkere, Y.G.S.Kouamé, S.Tembely, D.B.Kouamé, O.Ouattara, K.R.Dick
KeywordsChildren, Elastic stable intramedullary nailing, Femoral shaft fractures
Open access – Yes
SpecialityPaediatric surgery, Trauma and orthopaedic surgery
World region Western Africa
Country: Ivory Coast
Language – English
Submitted to the One Surgery Index on July 18, 2018 at 12:00 am
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.

OSI Number – 10101
PMID – 26215090

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