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Comparison of Noncontact Plating with Conventional Methods and Osteosynthesis Techniques in the Treatment of Pediatric Femoral Fractures

Year 2023, Volume: 6 Issue: 2, 332 - 337, 31.08.2023

Mesut Uluöz Ahmet Kapukaya

https://doi.org/10.36516/jocass.1345285

Abstract

Introduction: Studies on surgical options in pediatric femoral fractures have been continuing for many years. We aimed to compare the noncontact plating we applied with the other techniques.
Material and Methods: Pediatric patients treated for femoral shaft fracture were included. The patients were evaluated in terms of fracture type, time until surgery, duration of surgery, time of union, complications, Flynn criteria, radiological findings. 21 were in the elastic nailing (group 1), 27 were in the conventional plating (group 2), 11 were in the noncontact plating (group 3).
Results: The mean age was 8.3±1.4 (6-11) in group 1, 10.2±2.2 (7-15) in group 2, and 9.7±2.8 (7-15) in group 3. The time of union was 8.0±2.2 weeks (6-16) in group 1, 9.7±2.7 weeks (7-20) in group 2, and 7.1±1.0 weeks in group 3 (6 -9). In group 1, one patient had delayed union, two patients had a valgus deformity, two patients had minor wound site infection, and four patients had shortening of less than 2 cm. In group 2, three patients had a valgus deformity.Moreover, one patient underwent revision due to plate fracture. In group 3, no delayed union or deformity was observed in any patient.
Conclusion: The fact that elastic nailing, which is the most frequently recommended method in pediatric femoral fractures. However, it is obvious that conditions such as the absence of splinting, better reduction, fewer deformity, early rehabilitation provide advantages over noncontact plating. While it is up to the surgeon's preference, noncontact plating can be applied safely and successfully.

Keywords

Pediatric femoral fracture elastic nailing locked plating noncontact plating

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References

  • 1.Hedström EM, Svensson O, Bergström U, et al. Epidemiology of fractures in children and adolescents: Increased incidence over the past decade: a population-based study from northern Sweden. Acta Orthopaedica. 2010; 81(1): 148-53. https://doi.org/10.3109/17453671003628780
  • 2.Nakaniida A, Sakuraba K, Hurwitz EL. Pediatric Orthopaedic Injuries Requiring Hospitalization: Epidemiology and Economics. Journal of Orthopaedic Trauma. 2014; 28(3): 167-72. https://doi.org/10.1097/BOT.0b013e318299cd20
  • 3.Hughes BF, Sponseller PD, Thompson JD. Pediatric femur fractures: effects of spica cast treatment on family and community. J Pediatr Orthop. 1995;15(4):457-60. https://doi.org/10.1097/01241398-199507000-00009
  • 4.Liau GZQ, Lin HY, Wang Y, et al. Pediatric Femoral Shaft Fracture: An Age-Based Treatment Algorithm. Indian J Orthop. February 2021 ; 55(1):55-67. https://doi.org/10.1007/s43465-020-00281-6
  • 5.Li Y, Heyworth BE, Glotzbecker M, et al. Comparison of titanium elastic nail and plate fixation of pediatric subtrochanteric femur fractures. J Pediatr Orthop. May 2013; 33(3): 232-8. https://doi.org/10.1097/BPO.0b013e318288b496
  • 6.Sutphen SA, Mendoza JD, Mundy AC, Yang JG, Beebe AC, Samora WP, vd. Pediatric Diaphyseal Femur Fractures: Submuscular Plating Compared With Intramedullary Nailing. Orthopedics. November 2016; 39(6): 353-8. https://doi.org/10.3928/01477447-20160719-03
  • 7.Yıldırım A, Kapukaya A, Mertsoy Y, et al. Management of open fractures using a noncontact locking plate as an internal fixator. Indian J Orthop. june 2017; 51(3): 312-7. https://doi.org/10.4103/0019-5413.205686
  • 8.Yildirim A, Kapukaya A, Atiç R, et al. The Use of an "Internal Fixator Technique" to Stabilize Pathologic Fractures Developing Secondary to Osteomyelitis. Journal of Pediatric Orthopaedics. April 2017; 37(3): 222-226. https://doi.org/10.1097/BPO.0000000000000619
  • 9.Tuhanioğlu Ü, Oğur HU, Çiçek H, et al. Noncontact plating technique in an open fracture. TCRM. June 2017; 13:703-8. https://doi.org/10.2147/TCRM.S13674
  • 10.Ahmet Kapukaya. General Approach to Orthopedic Diseases. LİS; 2015. 171-3.
  • 11.Govindasamy R, Gnanasundaram R, Kasirajan S, et al. Elastic Stable Intramedullary Nailing of Femoral Shaft Fracture-Experience in 48 Children. Arch Bone Jt Surg. January 2018; 6(1): 39-46.
  • 12.Sanders JO, Browne RH, Mooney JF, Raney EM, Horn BD, Anderson DJ, vd. Treatment of femoral fractures in children by pediatric orthopedists: results of a 1998 survey. J Pediatr Orthop. August 2001; 21(4): 436-41. https://doi.org/10.1097/01241398-200107000-00004
  • 13.Lee SS, Mahar AT, Newton PO. Ender nail fixation of pediatric femur fractures: a biomechanical analysis. J Pediatr Orthop. August 2001; 21(4): 442-5. https://doi.org/10.1097/01241398-200107000-00005
  • 14.Heybeli M, Muratli HH, Celebi L, Gülçek S, Biçimoğlu A. The results of intramedullary fixation with titanium elastic nails in children with femoral fractures. Acta Orthop Traumatol Turc. 2004; 38(3): 178-87.
  • 15. Dırvar F, Derya Tunç O, Cengiz Ö, et al. Comparison of efficiency between submuscular plating and external fixation of spiral and comminuted fractures of the femur in 6-12 years old pediatric patients. Sisli Etfal. December 2016; 287-95. https://doi.org/10.5350/SEMB.20160624024007
  • 16.Chen X, Lu M, Xu W, Wang X, Xue M, Dai J, vd. Treatment of pediatric femoral shaft fractures with elastic stable intramedullary nails versus external fixation: A meta-analysis. Orthop Traumatol Surg Res. November 2020; 106(7): 1305-11. https://doi.org/10.1016/j.otsr.2020.06.012
  • 17.Heffernan MJ, Shelton W, Song B, Lucak TJ, Leonardi C, Kadhim M. Predictors of Open Reduction in Pediatric Femur Fractures Treated With Flexible Nails. J Pediatr Orthop. August 2020; 40(7): e566-71. https://doi.org/10.1097/BPO.0000000000001511
  • 18.Perren SM, Klaue K, Pohler O, et al. The limited contact dynamic compression plate (LC-DCP). Arch Orthop Trauma Surg. 1990; 109(6): 304-10. https://doi.org/10.1007/BF00636166
  • 19.Miclau T, Remiger A, Tepic S, et al. A mechanical comparison of the dynamic compression plate, limited contact-dynamic compression plate, and point contact fixator. J Orthop Trauma. February 1995; 9(1): 17-22. https://doi.org/10.1097/00005131-199502000-00003
  • 20.Ilizarov GA. Clinical application of the tension-stress effect for limb lengthening. Clin Orthop Relat Res. January 1990; (250): 8-26. https://doi.org/10.1097/00003086-199001000-00003
  • 21.Goodship AE, Kenwright J. The influence of induced micromovement upon the healing of experimental tibial fractures. J Bone Joint Surg Br. August 1985; 67(4): 650-5. https://doi.org/10.1302/0301-620X.67B4.4030869
  • 22.Aktekin CN, Oztürk AM, Altay M, et al. Flexible intramedullary nailing of children. TJTES April 2007; 13(2): 115-21.
  • 23.Moroz LA, Launay F, Kocher MS, Newton PO, Frick SL, Sponseller PD, vd. Titanium elastic nailing of fractures of the femur in children. Predictors of complications and poor outcome. J Bone Joint Surg Br. October 2006;88(10):1361-6. https://doi.org/10.1302/0301-620X.88B10.17517
  • 24.Eren OT, Küçükkaya M, Kabukçuoğlu YS, Balci V, Kuzgun U. [Plate fixation of closed femoral shaft fractures in adolescents]. Acta Orthop Traumatol Turc. 2002; 36(2): 124-8.
  • 25.Anderson SR, Nelson SC, Morrison MJ. Unstable Pediatric Femur Fractures: Combined Intramedullary Flexible Nails and External Fixation. J Orthop Case Rep. August 2017; 7(4): 32-5.

Year 2023, Volume: 6 Issue: 2, 332 - 337, 31.08.2023

Mesut Uluöz Ahmet Kapukaya

https://doi.org/10.36516/jocass.1345285

Abstract

Project Number

no

References

  • 1.Hedström EM, Svensson O, Bergström U, et al. Epidemiology of fractures in children and adolescents: Increased incidence over the past decade: a population-based study from northern Sweden. Acta Orthopaedica. 2010; 81(1): 148-53. https://doi.org/10.3109/17453671003628780
  • 2.Nakaniida A, Sakuraba K, Hurwitz EL. Pediatric Orthopaedic Injuries Requiring Hospitalization: Epidemiology and Economics. Journal of Orthopaedic Trauma. 2014; 28(3): 167-72. https://doi.org/10.1097/BOT.0b013e318299cd20
  • 3.Hughes BF, Sponseller PD, Thompson JD. Pediatric femur fractures: effects of spica cast treatment on family and community. J Pediatr Orthop. 1995;15(4):457-60. https://doi.org/10.1097/01241398-199507000-00009
  • 4.Liau GZQ, Lin HY, Wang Y, et al. Pediatric Femoral Shaft Fracture: An Age-Based Treatment Algorithm. Indian J Orthop. February 2021 ; 55(1):55-67. https://doi.org/10.1007/s43465-020-00281-6
  • 5.Li Y, Heyworth BE, Glotzbecker M, et al. Comparison of titanium elastic nail and plate fixation of pediatric subtrochanteric femur fractures. J Pediatr Orthop. May 2013; 33(3): 232-8. https://doi.org/10.1097/BPO.0b013e318288b496
  • 6.Sutphen SA, Mendoza JD, Mundy AC, Yang JG, Beebe AC, Samora WP, vd. Pediatric Diaphyseal Femur Fractures: Submuscular Plating Compared With Intramedullary Nailing. Orthopedics. November 2016; 39(6): 353-8. https://doi.org/10.3928/01477447-20160719-03
  • 7.Yıldırım A, Kapukaya A, Mertsoy Y, et al. Management of open fractures using a noncontact locking plate as an internal fixator. Indian J Orthop. june 2017; 51(3): 312-7. https://doi.org/10.4103/0019-5413.205686
  • 8.Yildirim A, Kapukaya A, Atiç R, et al. The Use of an "Internal Fixator Technique" to Stabilize Pathologic Fractures Developing Secondary to Osteomyelitis. Journal of Pediatric Orthopaedics. April 2017; 37(3): 222-226. https://doi.org/10.1097/BPO.0000000000000619
  • 9.Tuhanioğlu Ü, Oğur HU, Çiçek H, et al. Noncontact plating technique in an open fracture. TCRM. June 2017; 13:703-8. https://doi.org/10.2147/TCRM.S13674
  • 10.Ahmet Kapukaya. General Approach to Orthopedic Diseases. LİS; 2015. 171-3.
  • 11.Govindasamy R, Gnanasundaram R, Kasirajan S, et al. Elastic Stable Intramedullary Nailing of Femoral Shaft Fracture-Experience in 48 Children. Arch Bone Jt Surg. January 2018; 6(1): 39-46.
  • 12.Sanders JO, Browne RH, Mooney JF, Raney EM, Horn BD, Anderson DJ, vd. Treatment of femoral fractures in children by pediatric orthopedists: results of a 1998 survey. J Pediatr Orthop. August 2001; 21(4): 436-41. https://doi.org/10.1097/01241398-200107000-00004
  • 13.Lee SS, Mahar AT, Newton PO. Ender nail fixation of pediatric femur fractures: a biomechanical analysis. J Pediatr Orthop. August 2001; 21(4): 442-5. https://doi.org/10.1097/01241398-200107000-00005
  • 14.Heybeli M, Muratli HH, Celebi L, Gülçek S, Biçimoğlu A. The results of intramedullary fixation with titanium elastic nails in children with femoral fractures. Acta Orthop Traumatol Turc. 2004; 38(3): 178-87.
  • 15. Dırvar F, Derya Tunç O, Cengiz Ö, et al. Comparison of efficiency between submuscular plating and external fixation of spiral and comminuted fractures of the femur in 6-12 years old pediatric patients. Sisli Etfal. December 2016; 287-95. https://doi.org/10.5350/SEMB.20160624024007
  • 16.Chen X, Lu M, Xu W, Wang X, Xue M, Dai J, vd. Treatment of pediatric femoral shaft fractures with elastic stable intramedullary nails versus external fixation: A meta-analysis. Orthop Traumatol Surg Res. November 2020; 106(7): 1305-11. https://doi.org/10.1016/j.otsr.2020.06.012
  • 17.Heffernan MJ, Shelton W, Song B, Lucak TJ, Leonardi C, Kadhim M. Predictors of Open Reduction in Pediatric Femur Fractures Treated With Flexible Nails. J Pediatr Orthop. August 2020; 40(7): e566-71. https://doi.org/10.1097/BPO.0000000000001511
  • 18.Perren SM, Klaue K, Pohler O, et al. The limited contact dynamic compression plate (LC-DCP). Arch Orthop Trauma Surg. 1990; 109(6): 304-10. https://doi.org/10.1007/BF00636166
  • 19.Miclau T, Remiger A, Tepic S, et al. A mechanical comparison of the dynamic compression plate, limited contact-dynamic compression plate, and point contact fixator. J Orthop Trauma. February 1995; 9(1): 17-22. https://doi.org/10.1097/00005131-199502000-00003
  • 20.Ilizarov GA. Clinical application of the tension-stress effect for limb lengthening. Clin Orthop Relat Res. January 1990; (250): 8-26. https://doi.org/10.1097/00003086-199001000-00003
  • 21.Goodship AE, Kenwright J. The influence of induced micromovement upon the healing of experimental tibial fractures. J Bone Joint Surg Br. August 1985; 67(4): 650-5. https://doi.org/10.1302/0301-620X.67B4.4030869
  • 22.Aktekin CN, Oztürk AM, Altay M, et al. Flexible intramedullary nailing of children. TJTES April 2007; 13(2): 115-21.
  • 23.Moroz LA, Launay F, Kocher MS, Newton PO, Frick SL, Sponseller PD, vd. Titanium elastic nailing of fractures of the femur in children. Predictors of complications and poor outcome. J Bone Joint Surg Br. October 2006;88(10):1361-6. https://doi.org/10.1302/0301-620X.88B10.17517
  • 24.Eren OT, Küçükkaya M, Kabukçuoğlu YS, Balci V, Kuzgun U. [Plate fixation of closed femoral shaft fractures in adolescents]. Acta Orthop Traumatol Turc. 2002; 36(2): 124-8.
  • 25.Anderson SR, Nelson SC, Morrison MJ. Unstable Pediatric Femur Fractures: Combined Intramedullary Flexible Nails and External Fixation. J Orthop Case Rep. August 2017; 7(4): 32-5.
There are 25 citations in total.

Details

Primary Language English
Subjects Orthopaedics
Journal Section Articles
Authors

Mesut Uluöz 0000-0003-0319-3832

Ahmet Kapukaya 0000-0003-0623-0408

Project Number no
Publication Date August 31, 2023
Acceptance Date August 29, 2023
Published in Issue Year 2023 Volume: 6 Issue: 2

Cite

APA Uluöz, M., & Kapukaya, A. (2023). Comparison of Noncontact Plating with Conventional Methods and Osteosynthesis Techniques in the Treatment of Pediatric Femoral Fractures. Journal of Cukurova Anesthesia and Surgical Sciences, 6(2), 332-337. https://doi.org/10.36516/jocass.1345285
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