Clinical evaluation of end caps in elastic stable intramedullary nailing of femoral and tibial shaft fractures in children

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
Theddy F SlongoS M Berger

Abstract

Elastic stable intramedullary nailing (ESIN) may be complicated by the loss of reduction following push out of the nails at the entry site in unstable femoral and tibial fractures, especially in older and heavier children and following technical failures. An end cap system addressing this complication was evaluated clinically. In a retrospective case series, 49 femoral and five tibial fractures in 54 pediatric patients treated by ESIN and end caps were documented in two European tertiary centers. End caps were used to interlock standard ESIN nails. The results were evaluated regarding difficulties in the placement and removal of the end cap system, fracture stability and healing, and return to normal activities by analyzing patient charts and X-rays. Fifty-three of 54 fractures were stabilized sufficiently with ESIN and end caps. Loss of reduction was observed in one patient, requiring additional surgery. Six complications were observed, five of which were not related to end caps. There were no significant leg length differences or varus/valgus deformities. A rotational difference of >10°-20° was found in one patient. Removal of the end caps and nails was rated as simple and uncomplicated in 35/37 cases. End caps avoided postop...Continue Reading

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Citations

Jul 3, 2013·Journal of Children's Orthopaedics·Richard A K ReynoldsJean-Michel Clavert
Jun 2, 2011·BMC Medicine·Rozalia DimitriouPeter V Giannoudis
Aug 16, 2016·Materials Science & Engineering. C, Materials for Biological Applications·Leopold BergerAnnelie-Martina Weinberg
Jan 9, 2013·Current Opinion in Pediatrics·James Brousil, James B Hunter
Jul 13, 2016·Strategies in Trauma and Limb Reconstruction·Al-Achraf KhoriatiAlex Trompeter
Feb 3, 2021·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·Peter P Schmittenbecher
Apr 12, 2021·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Sean DuffyFergal Monsell
Aug 3, 2021·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Justus LieberJörg Fuchs

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