Pediatric Diaphyseal Femur Fractures: Submuscular Plating Compared With Intramedullary Nailing.

Abstract:

: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. Treatment outcomes were compared for statistical significance, including time to union, malunion, nonunion, heterotopic ossification, avascular necrosis, time to full weight bearing, limb length discrepancy, residual limp, painful hardware, and infection. The study identified 198 femur fractures in 196 patients (mean age, 11.9 years). Each femur fracture was treated with submuscular plating (35), flexible intramedullary nailing (61), or rigid intramedullary nailing (102). Mean follow-up across the cohort was 48 weeks, ranging from 12 to 225 weeks. Flexible nailing was associated with an increased incidence of malunion (P<.0001) and hardware irritation (P=.0204) and longer time to full weight bearing (P=.0018). Rigid nailing was associated with an increased incidence of limp at 12-week followup (P=.0412). Additionally, 23.5% of patients who were treated with rigid nailing had heterotopic ossification. Of all surgical methods, submuscular plating allowed for the most rapid return to full weight bearing (mean, 7 weeks) and offered the fastest healing rate (mean, 6 weeks). Submuscular plating resulted in faster times to union and full weight bearing, with minimal complication rates. Rigid intramedullary nailing with trochanteric entry resulted in a lower incidence of malunion and hardware-related complications; however, these patients had an increased incidence of heterotopic ossification and residual limp postoperatively. Flexible retrograde intramedullary nailing resulted in the highest rates of malunion and hardware irritation and the longest time to full weight bearing. [Orthopedics. 2016; 39(6):353-358.].

journal_name

Orthopedics

journal_title

Orthopedics

authors

Sutphen SA,Mendoza JD,Mundy AC,Yang JG,Beebe AC,Samora WP 3rd,Klingele KE

doi

10.3928/01477447-20160719-03

subject

Has Abstract

pub_date

2016-11-01 00:00:00

pages

353-358

issue

6

eissn

0147-7447

issn

1938-2367

journal_volume

39

pub_type

杂志文章
  • The effect of anaerobiosis on antistaphylococcal antibiotics.

    abstract::The activity of eight antimicrobial agents which might be used in the treatment of staphylococcal osteomyelitis was tested under anaerobic conditions similar to those found in chronically infected bone. An agar-dilution method was employed to determine the minimum inhibitory concentrations of tobramycin, vancomycin, t...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Tsukayama DT,Guay DR,Gustilo RB,Wicklund B,Gruninger R,Peterson PK

    更新日期:1988-09-01 00:00:00

  • Course of avascular necrosis of femoral head without collapse of femoral head at first examination: minimum 8-year follow-up.

    abstract::Disruption of the femoral head contour by collapse of necrotic segments is considered to be an important turning point in the history of avascular necrosis of the femoral head, and in many cases, surgical treatment is required soon after the onset of symptoms. However, in a few cases, conservative treatment is suffici...

    journal_title:Orthopedics

    pub_type: 临床试验,杂志文章

    doi:

    authors: Niimi R,Sudo A,Hasegawa M,Uchida A

    更新日期:2008-08-01 00:00:00

  • Patellofemoral pain--a prospective study.

    abstract::This prospective study confirms that patellofemoral pain arises predominantly in a young population and is more common in females. Patellar malalignment and its progression to patellar subluxation can be managed conservatively with improvement in the majority of cases. Arthroscopic lateral release may be necessary for...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Yates C,Grana WA

    更新日期:1986-05-01 00:00:00

  • The risk of venous thromboembolism in the orthopedic patient: epidemiological and physiological data.

    abstract::ABSTRACTVenous thromboembolism is responsible for 500,000 deaths annually in industrialized countries. It is probably the most common preventable cause of death in elective orthopedic surgery patients. Rates of deep vein thrombosis (DVT) and fatal pulmonary embolism (PE) in unprotected orthopedic patient populations a...

    journal_title:Orthopedics

    pub_type: 社论

    doi:10.3928/0147-7447-19970202-05

    authors: Paiement GD,Mendelsohn C

    更新日期:1997-02-01 00:00:00

  • Operative management of acute PCL injuries with associated pathology: long-term results.

    abstract::Eighteen consecutive patients with posterior cruciate ligament injury and associated pathology were reviewed. All were re-examined with an average follow up of 5.4 years (range: 3.5 to 7.5). Six posterior cruciate ligaments were repaired to the femur with multiple #2 nonabsorbable suture, and one "mop end" mid-substan...

    journal_title:Orthopedics

    pub_type: 杂志文章,评审

    doi:

    authors: Barrett GR,Savoie FH

    更新日期:1991-06-01 00:00:00

  • Tendon healing in vivo: effect of mannose-6-phosphate on flexor tendon adhesion formation.

    abstract::The purpose of this study was to investigate the preventive effect of mannose-6-phosphate on flexor tendon adhesion formation. From a total of 84 adult New Zealand White rabbits, 36 were randomly divided into 2 groups, the normal saline group and the mannose-6-phosphate group, after anastomosis of the flexor tendons. ...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20120621-21

    authors: Xia C,Zuo J,Wang C,Wang Y

    更新日期:2012-07-01 00:00:00

  • Historical update and new developments on the EMG-force relationships of skeletal muscles.

    abstract::The EMG-force relationships of skeletal muscles are of significant interest to the orthopedic-biomechanics researcher and have been a topic of interest and controversy for the last three decades. We present the developments reported in the literature, from the early 1950s, relevant to this topic, outlining the details...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Solomonow M,Baratta R,Zhou BH,Shoji H,D'Ambrosia R

    更新日期:1986-11-01 00:00:00

  • Arthrodesis by the distraction-compression method using a stainless steel implant.

    abstract::A new process for arthrodesis in humans is presented. The process has been used successfully in the cervical spine of horses and has potential for human use. The concept is encompassed in the process of an anterior cervical fusion and is an adaptation of that established practice but using an implant of stainless stee...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Bagby GW

    更新日期:1988-06-01 00:00:00

  • Thyroid acropachy.

    abstract::Thyroid acropachy is a rare complication of thyroid disease most often occurring in patients with a long history of active Graves' disease with ophthalmopathy and dermopathy already present. It presents with digital clubbing and soft tissue swelling with possible pain in the digits. Plain radiographs show a solid peri...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20080101-38

    authors: Batal O,Hatem SF

    更新日期:2008-01-01 00:00:00

  • Medium- and long-term results of open reduction and internal fixation for unstable pelvic ring fractures.

    abstract::Over a 10-year period, 74 patients with unstable pelvic injuries were treated with open reduction and internal fixation. Radiographic and clinical follow-up averaged 71 months (range: 38-141 months). Satisfactory (ie, good and very good) radiographic results were obtained in 90% of patients. Clinical results were supe...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Korovessis P,Baikousis A,Stamatakis M,Katonis P

    更新日期:2000-11-01 00:00:00

  • Economic and Educational Impact of Firearm-Related Injury on an Urban Trauma Center.

    abstract::As nonfatal firearm-related injuries continue to increase, calculating the financial cost these injuries have on an urban trauma center may help justify funding for intervention programs. The impact these injuries have on orthopedic resident education may lead to changes in the training of some urban-based programs. T...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20151228-02

    authors: Russo R,Fury M,Accardo S,Krause P

    更新日期:2016-01-01 00:00:00

  • Pigmented villonodular synovitis: a clinical analysis of twenty-four cases treated at Henry ford hospital.

    abstract::This article describes the clinical findings, roentgenographic manifestations, gross and microscopic pathology, treatment, and results of 24 cases of pigmented villonodular synovitis treated at Henry Ford Hospital over a period of 25 years. We conclude that synovectomy is the treatment of choice, and we have experienc...

    journal_title:Orthopedics

    pub_type: 社论

    doi:10.3928/0147-7447-19800801-05

    authors: Wu KK,Ross PM,Guise ER

    更新日期:1980-08-01 00:00:00

  • Soft tissue constraint injuries in complex elbow instability: prevalence, pathoanatomy, and classification.

    abstract::The types and prevalence of soft tissue constraint injuries associated with complex elbow instability have been rarely investigated. The purpose of this study was to analyze the intraoperative findings of soft tissue constraint injuries in complex elbow instability and provide a comprehensive classification of these l...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20121120-18

    authors: Giannicola G,Polimanti D,Sacchetti FM,Scacchi M,Gumina S,Greco A,Cinotti G

    更新日期:2012-12-01 00:00:00

  • Non-traumatic atlantoaxial subluxation in an adult secondary to retropharyngeal abscess.

    abstract::Non-traumatic atlantoaxial subluxation in an adult due to retropharyngeal abscess has been only sporadically reported. This article presents such a case treated non-surgically, with discussion of clinical presentation, diagnosis, pathogenesis, and treatment. The differential diagnosis of non-traumatic atlantoaxial sub...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Robertson S,Pinstein ML,LaVelle DG

    更新日期:1987-11-01 00:00:00

  • Infantile tibia vara: correction of recurrent varus deformity following epiphyseolysis.

    abstract::Infantile tibia vara (infantile Blount's disease) is a condition in which progressive varus of the knee develops due to diminished physeal growth of the medial aspect of the proximal tibia. A 6-year-old boy with severe bilateral infantile tibia vara (Langenskiold stage V) underwent operative correction of his deformit...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20080501-10

    authors: Gary J,Richards BS

    更新日期:2008-05-01 00:00:00

  • Functional Outcomes in High-function-demand patients after total knee arthroplasty.

    abstract::Total knee arthroplasty is a safe last-resort treatment for osteoarthritis that has excellent results in low-function-demand elderly patients. Current implants offer the same results in high-function-demand patients. However, supportive data do not exist.One-year Krackow Activity Scores (KAS) of 552 patients from 2 pr...

    journal_title:Orthopedics

    pub_type: 杂志文章,多中心研究

    doi:10.3928/01477447-20120426-22

    authors: Lozano Calderón SA,Shen J,Doumato DF,Zelicof S

    更新日期:2012-05-01 00:00:00

  • Idiopathic osteoarthritis of the hip: incidence, classification, and natural history of 272 cases.

    abstract::Long-term clinical and radiographic data of 210 patients (272 hips) with idiopathic hip osteoarthritis were reviewed. Of the 272 hips, 218 (80%) were eccentric and 54 (20%) were concentric. In eccentric hips, the femoral head migrated superolaterally or superomedially, because of the eccentric development of the degen...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Hartofilakidis G,Karachalios T

    更新日期:2003-02-01 00:00:00

  • A novel technique using sensor-based technology to evaluate tibial tray rotation.

    abstract::Rotational tibiofemoral congruency and centralized patellar tracking are critical technical factors that affect the postoperative success of total knee arthroplasty (TKA). Several techniques are used to position the femoral component, but there is no validated method for achieving the ideal rotational position of the ...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20150305-60

    authors: Roche MW,Elson LC,Anderson CR

    更新日期:2015-03-01 00:00:00

  • A Single-Incision Technique for Distal Biceps Repair Using a Flexible Reamer.

    abstract::Distal biceps tendon ruptures are rare injuries that usually occur in middle-aged men. Most of these injuries are repaired acutely to restore preinjury function and strength. There is concern regarding the higher prevalence of certain complications with the double-incision technique. As such, the single-incision techn...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20170615-03

    authors: Pierce TP,Pierce CM,Issa K,McInerney VK,Festa A,Scillia AJ

    更新日期:2017-07-01 00:00:00

  • Three-Year Follow-up of Conservative Treatments of Shoulder Osteoarthritis in Older Patients.

    abstract::Little is known about the mid-term results of nonsurgical treatment for shoulder osteoarthritis (OA), especially in a Chinese population. This study sought to determine the efficacy of nonsurgical management in older patients with shoulder OA. A total of 129 conservatively treated unilateral shoulder OA patients who w...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20160606-02

    authors: Guo JJ,Wu K,Guan H,Zhang L,Ji C,Yang H,Tang T

    更新日期:2016-07-01 00:00:00

  • Metal Allergy as a Cause of Implant Failure in Shoulder Arthroplasty.

    abstract::Metal allergy is an uncommon and poorly understood cause of failure of orthopedic implants. To the authors' knowledge, there have been no reports of the management of shoulder arthroplasty patients with metal allergy. The authors present their experience with the diagnosis and management of patients with metal allergy...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20170719-01

    authors: Ko JK,Nicholson TA,Hoffler CE,Williams G Jr,Getz C

    更新日期:2017-09-01 00:00:00

  • Bilateral simultaneous femoral diaphyseal fractures in a patient with long-term ibandronate use.

    abstract::Bisphosphonates are the most common medication used to treat patients with documented osteoporosis. Recently, reports have associated long-term bisphosphonate use with low-energy femur fractures. While no definitive mechanism has been associated, bisphosphonate use has been strongly implicated. This article presents t...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20100826-31

    authors: Patel VC,Lazzarini AM

    更新日期:2010-10-11 00:00:00

  • Plating of a periarticular medial clavicle fracture.

    abstract::This article describes a case of a 23-year-old man who sustained a far medial fracture dislocation of the medial clavicle. We performed an open reduction and internal fixation of the fragment back to the remaining medial fragment using a small locking plate. This fracture can be problematic and usually requires reduct...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20090501-08

    authors: McKenna M

    更新日期:2009-05-01 00:00:00

  • Expanded spectrum of organisms causing osteomyelitis after puncture wounds of the foot.

    abstract::Although there is a general awareness developing about the role of Pseudomonas aeruginosa in producing osteomyelitis following puncture wounds of the foot, it is not generally appreciated that other organisms may gain access to the bones of the foot following penetrating injuries. This paper addresses two additional c...

    journal_title:Orthopedics

    pub_type: 社论

    doi:10.3928/0147-7447-19810501-04

    authors: Congeni BL,Weiner DS,Izsak E

    更新日期:1981-05-01 00:00:00

  • Treatment strategies for intramedullary nailing of femoral shaft fractures.

    abstract::Intramedullary nailing has become the gold standard to treat femoral shaft fractures. It is unknown which nailing technique orthopedic surgeons prefer. The goal of this study was to determine current techniques and perioperative complications of intramedullary nailing of diaphyseal femoral fractures. Fifty-one institu...

    journal_title:Orthopedics

    pub_type: 杂志文章,多中心研究

    doi:10.3928/01477447-20100826-15

    authors: Wild M,Gehrmann S,Jungbluth P,Hakimi M,Thelen S,Betsch M,Windolf J,Wenda K

    更新日期:2010-10-11 00:00:00

  • Posterior stabilization of unstable sacroiliac injuries with the Texas Scottish Rite Hospital spinal instrumentation.

    abstract::This article describes a new alternative technique for stabilization of unstable sacroiliac injuries using the Texas Scottish Rite Hospital (TSRH) instrumentation. The TSRH instrumentation was applied in 14 consecutive patients with unstable posterior pelvic ring disruptions. All patients underwent follow-up for an av...

    journal_title:Orthopedics

    pub_type: 临床试验,杂志文章

    doi:

    authors: Korovessis P,Stamatakis M,Baikousis A

    更新日期:2000-04-01 00:00:00

  • Subtrochanteric transverse shortening osteotomy in cementless total hip arthroplasty achieved using a modular stem.

    abstract::It is challenging to reconstruct normal hip motion after a high hip dislocation. Although total hip arthroplasty (THA) with shortening osteotomy is a solution for high hip dislocation, osteotomy nonunion is a major complication. To improve the rate of osteotomy union, subtrochanteric transverse shortening osteotomy wa...

    journal_title:Orthopedics

    pub_type: 临床试验,杂志文章

    doi:10.3928/01477447-20110124-24

    authors: Ogawa H,Ito Y,Shinozaki M,Matsumoto K,Shimizu K

    更新日期:2011-03-11 00:00:00

  • 3D CT analysis of combined cup and stem anteversion in cases of cup navigation in hip arthroplasty.

    abstract::Navigation of the cup in total hip arthroplasty is well analyzed and shows accurate results, reducing cup outliers of Lewinnek's "safe zone." With regard to the combined anteversion of cup and stem, however, a "new" safe zone with a range of 25° to 50° has been published. The aim of this study was to analyze total ant...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20100510-53

    authors: Wassilew GI,Perka C,Koenig C,Janz V,Asbach P,Hasart O

    更新日期:2010-10-01 00:00:00

  • Postlaminectomy kyphosis in an achondroplastic adolescent treated for spinal stenosis.

    abstract::We report a case of a skeletally immature achondroplastic adolescent with significant thoracolumbar lordosis who presented with neurogenic claudication and urinary incontinence progressing over a 1-year period. She underwent decompressive lumbar laminectomy from T12 to L5 with preservation of the facet joints. Over th...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20080201-01

    authors: Agabegi SS,Antekeier DP,Crawford AH,Crone KR

    更新日期:2008-02-01 00:00:00

  • The treatment of olecranon fractures by excision or fragments and repair of the extensor mechanism: historical review and report of 12 fractures.

    abstract::The operative treatment of olecranon fractures is controversial. Proponents of open reduction and internal fixation cite restoration of anatomy and rigid fixation, while proponents of excision of fracture fragments with repair of the extensor mechanism cite few complications and a rapid return of motion and function. ...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Inhofe PD,Howard TC

    更新日期:1993-12-01 00:00:00