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Femoral shaft fractures in children with non-ambulatory neuromuscular disorders can be effectively treated using flexible intramedullary nails.
Siddiqui, Ali A; Illingworth, Kenneth D; Abousamra, Oussama A; Meisel, Erin M; Kay, Robert M.
Afiliação
  • Siddiqui AA; Children's Orthopaedic Center, Children's Hospital Los Angeles, USA.
  • Illingworth KD; Keck School of Medicine of University of Southern California, USA.
  • Abousamra OA; Children's Orthopaedic Center, Children's Hospital Los Angeles, USA.
  • Meisel EM; Keck School of Medicine of University of Southern California, USA.
  • Kay RM; Children's Orthopaedic Center, Children's Hospital Los Angeles, USA.
J Child Orthop ; 14(2): 132-138, 2020 Apr 01.
Article em En | MEDLINE | ID: mdl-32351626
PURPOSE: There is little information in the literature regarding flexible intramedullary nails (FIN) for treating femur fractures in children with neuromuscular disorders. The purpose of this study is to investigate the outcomes of FIN for femoral shaft fractures in non-ambulatory children with neuromuscular disorders. METHODS: A retrospective review was conducted on patients with femur fractures at a paediatric hospital between 2004 and 2018. Inclusion criteria were femoral shaft fracture treated with FIN. Outcomes were compared between patients with neuromuscular disorders (NM group) and a control group of those without neuromuscular disorders. RESULTS: A total of 37 patients with 37 femoral shaft fractures were studied (12 patients in the NM group and 25 in the control group). All NM group patients were non-ambulatory at baseline. Fractures were length stable in all 25 patients in the control group and in 2/12 (17%) patients in the NM group. All fractures healed in both groups. Three complications (all nail migrations) requiring reoperation before fracture union occurred in the NM group, yielding a major complication rate of 25% (3/12) in the NM group versus 0% (0/25) in controls (p = 0.03). Angular deformity occurred in 5/12 (42%) NM group patients and 1/25 (4%) control group patient (p = 0.009); none required reoperation. CONCLUSION: Femur fractures in non-ambulatory children with neuromuscular disorders can be successfully treated with FIN. Angular deformities are common in this population, but had no functional impact in the non-ambulatory NM group patients. Surgeons must also be vigilant for implant prominence and skin breakdown in these patients. LEVEL OF EVIDENCE: III.
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Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2020 Tipo de documento: Article