Kirmani Tabish Tahir, Huda Najmul, Mishra Gaurav
Department of Orthopedics, Teerthanker Mahaveer Medical College and Research Center Moradabad 244001, Uttar Pradesh, India.
Int J Burns Trauma. 2020 Aug 15;10(4):127-136. eCollection 2020.
Flexible intramedullary nailing (FIN) has become the standard treatment for pediatric femoral fractures in the 6-14 years age group. The other treatment options include traction plus spica casting and external fixation. In spite of excellent results described, there is disunity in the orthopedic fraternity regarding its usefulness and nail material. The aim of our study is to determine the outcome of pediatric femur fractures treated with Stainless steel FIN.
Between 2014 to 2018, 45 children within the age group of 6-12 years with femoral shaft fractures were included in the study. Two Stainless steel nails of predetermined size were inserted in a retrograde fashion under fluoroscopy. Patients were followed up at regular intervals to assess clinical and radiological parameters. Final results were evaluated using Flynn's clinical criteria.
There were 29 boys and 16 girls with an average age of 10.2 years. Fracture patterns included transverse (n=8), oblique (n=20), spiral (n=12) and comminuted (n=5). Open injuries were present in two cases and five patients had associated injuries. The mean injury to surgery interval was 2.9 days, mean hospital stay was 4.8 days and mean time to union was nine weeks. Complications included deep infection with delayed union in one case, superficial infection in two cases, malunion in three cases, limb length discrepancy of >10 mm in one patient and skin irritation from prominent nail tips in five patients. Results were excellent in 36 patients, satisfactory in eight patients and poor in one patient.
FIN is safe, reliable and efficacious method of fixation because of its simplicity, minimal invasiveness, ease of insertion and removal with better cosmesis, rapid union with short rehabilitation, less psychosocial stress to the patient and family.
弹性髓内钉固定术（FIN）已成为6 - 14岁儿童股骨干骨折的标准治疗方法。其他治疗选择包括牵引加髋人字石膏固定和外固定。尽管已有出色的治疗效果报道，但骨科界对于其有效性和钉材料仍存在分歧。我们研究的目的是确定采用不锈钢弹性髓内钉治疗儿童股骨干骨折的疗效。
2014年至2018年期间，本研究纳入了45例6 - 12岁股骨干骨折患儿。在透视引导下逆行插入两根预定尺寸的不锈钢钉。定期对患者进行随访，以评估临床和放射学参数。最终结果采用弗林临床标准进行评估。
共有29名男孩和16名女孩，平均年龄为10.2岁。骨折类型包括横形骨折（n = 8）、斜形骨折（n = 20）、螺旋形骨折（n = 12）和粉碎性骨折（n = 5）。2例为开放性损伤，5例患者伴有其他损伤。受伤至手术的平均间隔时间为2.9天，平均住院时间为4.8天，平均愈合时间为9周。并发症包括1例深部感染伴延迟愈合、2例浅表感染、3例畸形愈合、1例患者肢体长度差异>10 mm以及5例患者因钉尖突出导致皮肤刺激。36例患者结果优秀，8例患者结果满意，1例患者结果差。
弹性髓内钉固定术是一种安全、可靠且有效的固定方法，因其操作简单、微创、易于插入和取出、美观性好、愈合快、康复期短、对患者及其家庭的心理社会压力小。
