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Flexible nail

J F Maempel, O D Stone, A W Murray
Introduction Surgical procedures to manage trauma to the wrist, forearm and elbow in children are very common. Image intensifiers are used routinely, yet studies/guidelines that quantify expected radiation exposure in such procedures are lacking. Methods Information on demographics, injury type, surgeon grade and dose area product (DAP) of radiation exposure per procedure was collected prospectively for 248 patients undergoing manipulation/fixation of injuries to the elbow, forearm or wrist at a paediatric hospital over 1 year...
September 2016: Annals of the Royal College of Surgeons of England
Michael J Beltran, Cory A Collinge, Michael J Gardner
Stress modulation is the concept of manipulating bridge plate variables to provide a flexible fixation construct that allows callus formation through uneventful secondary bone healing. Obtaining absolute stability through the anatomic reduction of all fracture fragments comes at the expense of fracture biology, whereas intramedullary nailing, which is more advantageous for diaphyseal fractures of the lower extremity, is technically demanding and often may not be possible when stabilizing many metaphyseal fractures...
October 2016: Journal of the American Academy of Orthopaedic Surgeons
Leopold Berger, Johannes Eichler, E Jonathan S Ryll, Stefan Fischerauer, Michael J Raschke, Andreas Kolbitsch, Christoph Castellani, Annelie-Martina Weinberg
Flexible intramedullary nailing (FIN) is a minimally invasive and widespread standard method for osteosynthesis of pediatric long bone fractures. In the case of unstable fractures of the lower extremity, interlocking systems need to be used to prevent axial shortening and subsequent perforation of the nail at its insertion site. In the present study, four different screw-fixed interlocking systems for FINs (Hofer TwinPlug with two 3-mm titanium interlocking screws, Hofer FixPlug with 3-mm titanium interlocking screw, Hofer Plug with 3...
November 1, 2016: Materials Science & Engineering. C, Materials for Biological Applications
Sean A Sutphen, Juan D Mendoza, Andrew C Mundy, Jingzhen G Yang, Allan C Beebe, Walter P Samora, Kevin E Klingele
This study compared the radiographic and clinical outcomes of pediatric diaphyseal femur fractures treated by submuscular plating, flexible retrograde intramedullary nailing, or rigid antegrade intramedullary nailing with a trochanteric entry point in skeletally immature patients who were 8 years and older. A retrospective review was conducted of skeletally immature patients 8 years and older who were treated for femur fracture with submuscular plating, flexible intramedullary nailing, or rigid intramedullary nailing from 2001 to 2014 with a minimum 12-week follow-up...
July 25, 2016: Orthopedics
Yong Cheng Guo, Guo Ming Feng, Guang Wei Xing, Jin Neng Yin, Bing Xia, Yan Zhao Dong, Xue Qiang Niu, Qianyi He, Pengfei Hu
To compare the difference in efficacy following flexible intramedullary nailing (FIN) and external fixation (EF) for pediatric femoral shaft fractures. A systematic search was performed on PubMed, Embase, Medline, and Cochrane library for relevant studies. We included controlled trials comparing complications between FIN and EF for pediatric femoral shaft fractures published before 25 November 2014. Modified Jadad scores were utilized to assess the methodological quality of the studies included. The meta-analysis was carried out using Stata 12...
September 2016: Journal of Pediatric Orthopedics. Part B
Jingjiang Xu, Wei Wei, Shaozhen Song, Xiaoli Qi, Ruikang K Wang
Recent advances in optical coherence tomography (OCT)-based angiography have demonstrated a variety of biomedical applications in the diagnosis and therapeutic monitoring of diseases with vascular involvement. While promising, its imaging field of view (FOV) is however still limited (typically less than 9 mm(2)), which somehow slows down its clinical acceptance. In this paper, we report a high-speed spectral-domain OCT operating at 1310 nm to enable wide FOV up to 750 mm(2). Using optical microangiography (OMAG) algorithm, we are able to map vascular networks within living biological tissues...
May 1, 2016: Biomedical Optics Express
Derek M Kelly
Most proximal and diaphyseal pediatric humeral fractures can be treated successfully by closed means; however, certain patient factors or fracture characteristics may make surgical stabilization with flexible intramedullary nails (FIN) a better choice. Common indications for FIN of pediatric humeral fractures include unstable proximal-third fractures in children nearing skeletal maturity, unstable distal metaphyseal-diaphyseal junction fractures, shaft fractures in polytraumatized patients or patients with ipsilateral both-bone forearm fractures (floating elbow), and prophylactic stabilization of benign diaphyseal bone cysts or surgical stabilization of pathologic fractures...
June 2016: Journal of Pediatric Orthopedics
James Shaha, Jason M Cage, Sheena Black, Robert L Wimberly, Steven H Shaha, Anthony I Riccio
BACKGROUND: Flexible intramedullary nailing (FIMN) of femoral shaft fractures in children >100 pounds remains controversial. The purpose of this study is to assess the relationship between patient weight and alignment at radiographic union following Ender's FIMN of pediatric femoral shaft fractures. METHODS: An IRB approved, retrospective review of all patients who sustained a femoral shaft fracture treated by retrograde, stainless-steel Ender's FIMN was performed at a level 1 pediatric trauma center from 2005 to 2012...
April 30, 2016: Journal of Pediatric Orthopedics
Sinan Zehir, Murat Çalbıyık, Ercan Şahin, Deniz İpek
OBJECTIVE: The aim of this study was to compare the results of expandable flexible locked intramedullary nailing and anatomical locking plating in clavicular midshaft fractures. METHODS: Thirty-three patients (21 male, 12 female) who had displaced fractures and at least 2-cm shortening fixed with expandable flexible locked intramedullary nailing and 38 patients (24 male, 14 female) who underwent anatomical locking plating were recruited. Duration of surgery, incision size, duration of hospital stay, union time, and early and late complications were compared between the groups...
2016: Acta Orthopaedica et Traumatologica Turcica
Lindley B Wall
Pediatric diaphyseal forearm fractures occur commonly and often require reduction with stabilization. Intramedullary flexible nails provide an effective method for stabilizing and maintaining reduction of these fractures. There are a few specific technical pearls that can be implemented to improve efficiency of nail placement and minimize postoperative complications, such as painful hardware and compartment syndrome.
June 2016: Journal of Pediatric Orthopedics
Nirav K Pandya
Tibial shaft fractures are common injuries in the pediatric population, and can be treated conservatively the vast majority of the time. Yet, it is important to recognize that open and/or unstable tibial shaft fractures represent a different entity. Rigid intramedullary devices are generally contraindicated because of the skeletal immaturity of these patients, and external fixation is associated with a high complication rate. As a result, flexible nailing is being utilized with increasing frequency. It is essential for the clinician to understand the pearls and pitfalls associated with the utilization of these flexible nails; particularly in regards to their immediate use in the context of open fractures and the risk of compartment syndrome postoperatively after fixation...
June 2016: Journal of Pediatric Orthopedics
Christine A Ho
Despite the increasing popularity of operative treatment in adolescent tibia fractures, casting remains a viable first-line treatment. Because the selection bias in published reports does not allow direct comparison between casting and flexible nail treatment of closed pediatric tibia fractures, it is unclear whether flexible nailing offers any advantages over casting. This overview discusses parameters of acceptable alignment, indications, techniques for successful reduction and casting, subsequent inpatient and outpatient management including wedging of casted tibia fractures, expected outcomes, and comparison of casting with flexible nailing...
June 2016: Journal of Pediatric Orthopedics
Christopher A Iobst
Most tibia fractures in children can be treated nonoperatively. For fractures that do require surgery, however, the most common methods of management include plating or flexible nail insertion. Some fracture patterns, such as periphyseal fractures, fractures with bone and/or soft tissue loss, or fractures with delayed presentation, are not easily amenable to these techniques. Hexapod external fixators are especially helpful in these difficult cases. The purpose of this review is to discuss the principles of performing hexapod circular external fixation applied to pediatric tibia fractures...
June 2016: Journal of Pediatric Orthopedics
Barakat El-Alfy, Ayman M Ali, Sallam I Fawzy
Comminuted diaphyseal fractures in the pediatric age group represent a major orthopedic problem. It is associated with a high incidence of complications and poor outcomes because of the instability and difficulty in treatment. The aim of this study was to evaluate the efficacy of combined external skeletal fixation and flexible intramedullary nails in reconstruction of comminuted diaphyseal fracture in skeletally immature patients. Combined external fixator and elastic stable intramedullary nails were used in the management of 27 pediatric patients (15 males and 12 females) with unstable comminuted diaphyseal fractures of the tibia and femur...
September 2016: Journal of Pediatric Orthopedics. Part B
Isabella da Costa Gagliardi, Guilherme Grisi Mouraria, Bruno Funayama, Fernando Kenji Kikuta, Márcio Alves Cruz, Américo Zoppi
OBJECTIVE: : To evaluate the results of displaced radial neck fractures in children trated surgically with flexible titanium intramedullary nails. METHOD: : This is a retrospective study of five cases of radial neck fractures with displacement greater than 30° fixed with flexible intramedullary nails. Patients were evaluated regarding functional outcome through range of motion and the Mayo Elbow Performance Score (MEPS), as well as radiographic exams. RESULTS: : Five patients, with a mean age of 8...
March 2016: Acta Ortopedica Brasileira
Fei Liu, Li Ju, Kai Tang, Yue Lou
UNLABELLED: Our study aimed to compare the effectiveness and clinical outcomes of percutaneous joystick reduction and limited open reduction for flexible intramedullary nailing in the treatment of pediatric femoral shaft fractures. A total of 63 pediatric femoral shaft fractures were studied: 35 fractures were treated with percutaneous fixation using the K-wire pin as a joystick (group A), whereas 28 fractures were treated with limited open reduction (group B). Clinical and radiographic data at the final follow-up were compared between the surgical groups...
July 2016: Journal of Pediatric Orthopedics. Part B
Brandon A Ramo, Jeffrey E Martus, Naureen Tareen, Benjamin S Hooe, Mark C Snoddy, Chan-Hee Jo
BACKGROUND: Flexible intramedullary nailing (IMN) is a valuable tool in the treatment of femoral fractures in school-age children, whereas spica cast immobilization has been the standard of care for younger children. We compared these treatment modalities in a group of preschool-age children (four to five years of age). METHODS: A retrospective cohort of consecutive patients, four to five years of age, with an isolated, complete femoral shaft or subtrochanteric fracture treated with intramedullary nailing or early spica cast immobilization and followed until fracture-healing were identified from two centers...
February 17, 2016: Journal of Bone and Joint Surgery. American Volume
Selim Dereci, Tuğba Koca, Filiz Serdaroğlu, Mustafa Akçam
AIM: Foreign bodies ingested by the oral route enter into the gastrointestinal tract and are considered a significant health problem in the childhood. In this study, we evaluated the pediatric patients who presented to our hospital with the complaint of ingestion of foreign body. MATERIAL AND METHODS: The hospital records of all children who presented to our clinic because of ingestion of foreign body between January 2008 and January 2015 were examined retrospectively...
December 2015: Türk Pediatri Arşivi
K C Kapil Mani, R C Dirgha Raj, Acharya Parimal
BACKGROUND: Nowadays pediatric femoral fractures are more commonly managed with operative treatment rather than conservative treatment because of more rapid recovery and avoidance of prolonged immobilization. Children between the ages of 5-13 years are treated either by traction plus hip spica and flexible/elastic stable retrograde intramedullary nail, or external fixators in the case of open fractures. The aim of this study is to evaluate the outcome of pediatric femoral shaft fractures treated by stainless steel flexible intramedullary nail in children between 5 and 13 years of age...
2015: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Louise M Burke
During the period 1985-2005, studies examined the proposal that adaptation to a low-carbohydrate (<25 % energy), high-fat (>60 % energy) diet (LCHF) to increase muscle fat utilization during exercise could enhance performance in trained individuals by reducing reliance on muscle glycogen. As little as 5 days of training with LCHF retools the muscle to enhance fat-burning capacity with robust changes that persist despite acute strategies to restore carbohydrate availability (e.g., glycogen supercompensation, carbohydrate intake during exercise)...
November 2015: Sports Medicine
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