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7 "Flexible intramedullary nail"
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Original Articles
Operative Treatment of Pediatric Distal Forearm Bothbone Fracture
Sang Uk Lee, Changhoon Jeong, Il Jung Park, Jaeyoung Lee, Seman Oh, Kyung Hoon Lee, Sanghyun Jeon
J Korean Fract Soc 2015;28(4):237-244.   Published online October 31, 2015
DOI: https://doi.org/10.12671/jkfs.2015.28.4.237
AbstractAbstract PDF
PURPOSE
Pediatric patients with distal forearm bothbone fractures of surgical indication were treated with the Kapandji reduction technique for radius and flexible intramedullary nail for ulna at our institution. The purpose of this study is to evaluate clinical and radiological results.
MATERIALS AND METHODS
From February 2012 to June 2014, we retrospectively evaluated 16 out of 18 cases with distal forearm bothbone fractures treated with the Kapandji reduction technique for radius and flexible intramedullary nail for ulna with at least 1-year follow-up. The average age at operation was 9.1 years (7-13 years).
RESULTS
Adequate reduction for both radius and ulna was achieved for all cases, and none of the cases showed re-displacement until the last follow-up. Mean 6.6 weeks lapsed until bony union was observed for the radius. For the ulna, the mean was 6.5 weeks. All patients gained full wrist range of motion at the last visit.
CONCLUSION
For pediatric distal forearm bothbone fractures, intrafocal Kapandji reduction and internal fixation with Kirschner wire for radius and reduction and internal fixation with a flexible intramedullary nail for ulna is the technique for handy reduction. Use of this technique can prevent re-displacement during the union process and achieve excellent clinical and radiologic results.
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Flexible Intramedullary Nail Fixation of Pediatric Femoral Shaft Fracture
Suk Kyu Choo, Byung Jik Kim, Hyun Wook Chung
J Korean Fract Soc 2005;18(1):60-64.   Published online January 31, 2005
DOI: https://doi.org/10.12671/jkfs.2005.18.1.60
AbstractAbstract PDF
PURPOSE
To traditional treatment of pediatric femoral shaft fracture has been a traction and spica cast application. But flexible intramedullary nail fixation has been introduced as an alternative to other treatment modalities. With this in mind, we analyzed the clinical and radiologic results of flexible intramedullary nail fixation of pediatric femoral shaft fractures.
MATERIALS AND METHODS
We analyzed 12 patients (13 cases) who were treated with flexible intramedullary nail and followed up for at least 6 months at the department of Orthopedic Surgery, Inje University Ilsan Paik Hospital since May, 2002.
RESULTS
In all 12 patients (13 cases) involving 1 case with reoperation because of reduction failure, average duration of bone union was 12.6 weeks. There were no considerable complications except mild post-op knee pain and limitation of motion.
CONCLUSION
In spite of relatively short term study, a flexible intramedullary nail fixation seems to be a useful method without serious complications on pediatric femoral shaft fracture. However, in big or older pediatric patients, interlocking intramedullary nail fixation may be a better choice rather than a flexible nail fixation because of it's insufficient stability.
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Flexible Intramedullary Nailing in Children's Femoral Shaft Fractures
Yeo Hon Yun, Chang Ho Choi, Jae Hak Jung
J Korean Soc Fract 2003;16(3):385-391.   Published online July 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.3.385
AbstractAbstract PDF
PURPOSE
We report a treatment result and the pros-cons of the flexible intramedullary nailing for femoral shaft fractures in children between the ages of 4 and 11 years.
MATERIALS AND METHODS
During the recent three years, 28 femoral shaft fractures in 27 consecutive pediatric patients were treated with flexible intramedullary nailing. We retrospectively reviewed their clinical and radiological records, followed-up for at least one year, in respects to the recovery of knee joint motion; time of weight bearing; time of fracture union; period of admission and rehabilitation; angular deformity and leg length discrepancy; and other complications.
RESULTS
In all children, the knee joint motion was rapidly recovered to near normal range within 2~4 weeks. Partial weight bearing with wearing functional brace was possible within 2~4 weeks, while full weight bearing without brace was started until 6~12 (average 8.4) weeks after the nailing. In the last follow-up radiographs, five cases (18%) showed an angular deformity in any direction of more than 5 degrees. Two children represented leg length discrepancy of more than 1 cm. Other complications were one fixation failure, and one deep soft tissue infection at the entry point of the nail.
CONCLUSION
We strongly recommend the flexible intramedullary nailing in this injury because the fixation is strong enough to permit early knee motion and weight bearing in orthosis, the fracture healing was so rapid without any case of delayed or nonunion, and the incidences of residual angular deformity and leg length discrepancy were significantly less than the nonoperative treatment.

Citations

Citations to this article as recorded by  
  • Comparison of Flexible Intramedullary Nailing with External Fixation in Pediatric Femoral Shaft Fractures
    Do-Young Kim, Sung-Ryong Shin, Un-Seob Jeong, Yong-Wook Park, Sang-Soo Lee, Keun-Min Park
    The Journal of the Korean Orthopaedic Association.2008; 43(1): 30.     CrossRef
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Treatment of femoral diaphyseal fractures in children: Comparison between conservative treatment and retrograde flexible intramedullary nailing
Chang Wug Oh, Byung Chul Park, Joo Chul Ihn, Hyung Tae Soh, Seung Hoon Baek
J Korean Soc Fract 2002;15(2):292-298.   Published online April 30, 2002
DOI: https://doi.org/10.12671/jksf.2002.15.2.292
AbstractAbstract PDF
PURPOSE
To compare clinical outcomes and complications between pediatric patients with femoral shaft fracture who had undergone conservative treatment and retrograde flexible intramedullary nailing.
MATERIALS AND METHODS
51 cases of 46 pediatric patients who had femoral shaft fracture were retrospectively studied. Hip spica cast was applied 3~6 weeks after traction in 24 cases of conservative treatment group and closed reduction and internal fixation with flexible nails were performed in 27 cases.
RESULT
Neither pain, limitation of joint motion, nor nonunion was reported in both groups. In radiologic evaluation, 4 cases of angulation more than 10 degrees were observed in conservative treatment group and none of surgical treatment group. In leg length discrepancy(LLD) over 10 mm, there was none in surgical treatment group, but 4 cases were seen in the conservative group. Two cases of limping were observed only in the conservative group. Mean time to weight bearing was earlier in surgical treatment group(7.5 weeks) than that in the conservative group(10.8 weeks).
CONCLUSION
As treatment of pediatric femoral shaft fracture, retrograde flexible intramedullary nailing had less complications such as LLD and angulation and enabled earlier rehabilitation than conservative treatment.
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Retrograde Flexible Intramedullary Nailing of Pediatric Femur Fractures
Chang Wug Oh, Byung Chul Park, Hyung Jin Park
J Korean Soc Fract 2001;14(2):272-277.   Published online April 30, 2001
DOI: https://doi.org/10.12671/jksf.2001.14.2.272
AbstractAbstract PDF
PURPOSE
This study was designed to evaluate the clinical effectiveness including bone union, leg length discrepancy, after retrograde flexible intramedullary nailing for pediatric femoral fractures. MATERIAL AND METHOD: Nineteen cases (18 patients) with femur fracture at the age of 4 to 10 years (mean age 6.7) have been followed up over the minimum of one year. Under imaging intensifier, the fracture was temporarily reduced with manual traction, and 1 or 2 flexible nails were inserted at medial and lateral side of distal femur above the distal epiphysis. After two weeks of immobilization with long leg splint, joint motion was permitted. At 6-8 weeks, partial weight bearing was permitted, and at 10- 12 weeks, full weight bearing was permitted.
RESULTS
Time to radiologic union averaged 10.9 weeks. Limb length discrepancy ranged from 7mm of shortening to 6mm of overgrowth(mean ; 1.1mm of overgrowth), but there was no severe limb length discrepancy over 10mm. As another complications, there were one case of limited motion of knee joint and one case of broken nail.
CONCLUSION
We found that retrograde flexible intramedullary nailing is a safe, effective treatment for acute femoral shaft fractures in skeletally immature patients.

Citations

Citations to this article as recorded by  
  • Treatment of Femoral Shaft Fracture with Interlocking Humeral Nail in Older Children and Adolescent
    Kun-Bo Park, Hoon Park, Hyun-Woo Kim, Hui-Wan Park, Jae Young Roh
    Journal of the Korean Fracture Society.2010; 23(2): 206.     CrossRef
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Flexible Intramedullary Nailing for Femoral Shaft Fracture in Children
Kwang Pyo Jeon, Kyung Hoon Kang, Jin Il Kim, Dong Soo Kim, Hyung Koo Yoon, Chul Weon Kang
J Korean Soc Fract 1999;12(4):1051-1057.   Published online October 31, 1999
DOI: https://doi.org/10.12671/jksf.1999.12.4.1051
AbstractAbstract PDF
PURPOSE
: In children, fractures of the femoral shaft have been traditionally treated by immobilization in a spica cast, either immediately or after a period in traction except open fracture or for patient with head injuries. More recently, there has been a growing trend towards surgical treatment with widening of the indications including isolated femoral fractures. To evaluate the clinical, radiological results of surgical treatment for femoral shaft fractures in children, we reviewed 13 cases of femoral shaft fractures in children treated with flexible intramedullary nailing and followed for more than 12 months. MATERIALS & METHODS : The average age of the patients was 11 years and 4 months(range 10- 14 years). The average follow-up period was 1 years and 3 months(range 1 years-1 years and 8 months)after surgery. 10 cases and 3 cases were inserted through antegrade and retrograde entry, RESULTS: No major complications were found except 1 intraoperative iatrogenic fracture and 2 postoperative bursitis ;all fractures were united and radiologic union was obtained at 9.5 weeks after surgery.
CONCLUSION
: The clinical results obtained using flexible intramedullary nails for the stabilization of femoral shaft fracture in children are comparable to non-operative treatment, but with less disruption to family life and a shorter hospitalization while achieving near anatomic alingment, maintaining lengh, and allowing early active motion at the hip and knee.
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Ender Nailing of Humeral Shaft Fractures
DONG HEON KIM, KYU CHUL SHIN, KYEONG SOON KIM, SANG HAK LEE
J Korean Soc Fract 1997;10(3):614-620.   Published online July 31, 1997
DOI: https://doi.org/10.12671/jksf.1997.10.3.614
AbstractAbstract PDF
Most humeral shaft fractures are treated conservatively. However, in the event of failure of closed reduction, pathologic fractures, multiple fracture, multiple associated injury and severe neurologic disorder, operative treatment may be indicated. The purpose of this article is to evaluate the effectiveness of Ender nailing for the humeral shaft fracture of the patients who have multiple fracture, multiple associated injury and pathologic fractures. Authors treated 56 patients with humeral shaft fractures by flexible intramedu-llary stabilization- Ender nail or Ender nail with Rush pin 47 cases were treated closed method, 9 cases were treated by open method. Period of follow-up was average 16 weeks. Fractures were united by an average 12 weeks(range : 9 to 20 weeks). There were no non-union, infection and malunion. No backing out of nails occured. In conclusion, Ender nailing is effective treatment for the humeral shaft fracture to decrease hospital stay, to permit early range of motion of the shoulder and elbow joint.

Citations

Citations to this article as recorded by  
  • Contributing Factors of Radial Nerve Palsy Associated with Humeral Shaft Fracture
    Tae-Soo Park, Joon-Hwan Lee, Tai-Seung Kim, Kwang-Hyun Lee, Ki-Chul Park
    Journal of the Korean Fracture Society.2008; 21(4): 292.     CrossRef
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