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Órgano Oficial de la Sociedad Mexicana de Ortopedia Pediátrica

2004, Número 1

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Rev Mex Ortop Ped 2004; 6 (1)


Clavos centromedulares flexibles en el tratamiento de fracturas pediátricas

Ramírez JA, Berumen NE, Núñez JA, Vallejo J, Campbell O, Carlos PJ, Aguirre MA

Idioma: Español
Referencias bibliográficas: 101
Paginas: 6-17
Archivo PDF: 219.58 Kb.


RESUMEN

Antecedentes: El enclavado intramedular flexible es una técnica quirúrgica de invasión mínima intermedia entre el tratamiento incruento y conservador. Brinda las ventajas de ser una técnica percutánea, no lesiona cartílago de crecimiento, mantiene el hematoma fracturario intacto, otorga la suficiente estabilidad en los 3 planos para tolerar carga de peso precoz, rehabilitación temprana y disminución de los costos, con un mínimo de complicaciones. Material y métodos: Se incluyeron todos los pacientes tratados con clavos centromedulares flexibles de titanio desde noviembre del 2001 a marzo de 2004 en el Hospital Clínica del Parque. Bajo control fluoroscópico las fracturas de fémur, tibia y peroné fueron estabilizadas con dos clavos, las fracturas de antebrazo con un solo clavo. Resultados: Se obtuvo un total de 27 pacientes, rango de edad de 2 a 17 años de edad, catorce por fractura de fémur, nueve de antebrazo, dos tibioperonea, dos de húmero, estancia hospitalaria promedio de 3 días. Tiempo de consolidación promedio de 12 semanas. Un paciente presentó pseudoartrosis. Todos los niños volvieron a su nivel previo de funcionalidad y actividad física. Conclusiones: El enclavado intramedular flexible es una opción en el tratamiento de las fracturas diafisiarias en niños, con ventajas importantes en comparación con otros métodos, con un mínimo de complicaciones y excelentes resultados.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. . Rush LV. Dynamic intramedullary fracture fixation of the femur: reflections on the use of the round rod after thirty years. Clin Orthop 1968; 60: 21-7.

  2. Ender J, Simon-Weidner R. Fixierung trochanterere Frakturen mit elastischen Kondylennägeln. Acta Chir Austr 1970; 1: 40.

  3. Pankovitch AM. Flexible intramedullary nailing of long bone fractures: a review. J Orthop Trauma 1987; 1: 78-95.

  4. Keller HW, Huber R, Rehm KE. Die intramedulläre Schienung von Frakturen im Wachstumsalter mit einem neuen Implantat. Chirurg 1993; 64: 180-4.

  5. Ligier JN, Metaizeau JP, Prévot J. Closed flexible medullary nailing in pediatric traumatology. Chir Pediatr 1983; 24(6): 383-5.

  6. Metaizeau JP. L’osteosynthese chez l’enfant par embrochage centro medullaire elastique stable. Sauramps Medical Montpellier 1988.

  7. Ligier JN, Metaizeau JP, Prévot J, Lascombes P. Elastic stable intramedullary nailing of femoral shaft fractures in children. J Bone Joint Surg [Br] 1988; 70-B: 74-7.

  8. Burkey S. Current trends in the treatment of femoral shaft fractures in children and adolescents. Clin Ortoph 1997; 338: 60-73.

  9. Firica A y cols. Nuevos conceptos biomecánicos sobre la osteosíntesis elástica estable. Estudio experimental. Rev Chir Orthop 1980; 67II: 82-91.

  10. Hae-Ryong S, Chang-Wug O, Hyun-Dae S, Sung-Jung K, Hee-Soo K, Seung-Hoon B, Byung-Chul P, Joo-Chul I. Treatment of femoral shaft fractures in young children: comparison between conservative treatment and retrograde flexible nailing. Journal of Pediatric Orthopaedics B 2004; 13(4): 275-280.

  11. Reeves R et al. Internal fixation versus traction and casting of adolescent femoral shaft fractures. J Pediatric Orthop 1990; 10: 592-595.

  12. Newton P, Mubarak S. Financial aspects of femoral shaft fracture treatment in children and adolescents. J Pediatric Orthop 1994; 14: 508-512.

  13. Flynn JM, Hresko T, Reynolds RA, Blasier RD, Davidson R, Kasser J. Titanium elastic nails for pediatric femur fractures: a multicenter study of early results with analysis of complications. J Pediatr Orthop 2001; 21: 4-8.

  14. Dravick DM et al. Operative treatment of pediatric femur fractures using flexible intramedullary nails: a prospective study. 59th Annual Meeting of The American Academy of Orthopaedic Surgeons. Washington, 1992.

  15. Hofmann VKHS. (Comparison of surgical and conservative treatment methods as exemplified in the juvenile femur). Z. Unfallchir. Versicherungsmed. Berufskr 1989; 82(4): 236-42.

  16. Irani RN, Nicholsen JT, Chung MK. Long-term results in the treatment of femoral-shaft fractures in young children by immediate spice immobilization. J Bone Joint Surg (Am): 1976; 58A(7): 945-951.

  17. Kissel EU, Miller ME. Closed ender nailing of fractures in older children. J Trauma 1989; 29: 1585-1588.

  18. Matthews LS, Kaufer H, Garver DF, Sonstegard DA. The effect on supination-pronation of angular malalignment of fractures of both bones of the forearm. J Bone Joint Surg [Am] 1982; 64: 14-7.

  19. Roberts JA. Angulation of the radius in children’s fractures. J Bone Joint Surg [Br] 1986; 68: 751-4.

  20. Creasman C, Zaleske DJ, Ehrlich MG. Analyzing forearm fractures in children: the more subtle signs of impending problems. Clin Orthop 1984; 188: 40-53.

  21. Thomas EM, Tuson WR, Browne SH. Fractures of the radius and ulna in children. Injury 1975; 7: 120-4.

  22. Voto SJ, Weiner DS, Leighley B. Redisplacement after closed reduction of forearm fractures in children. J Pediatr Orthop 1990; 10: 79-84.

  23. Fiala M, Carey TP. Pediatric forearm fractures: an analysis of refracture rate. Orthop Trans 1995; 18: 1265-6.

  24. Price CT, Scott DS, Kurzner ME, Flynn JC. Malunited forearm fractures in children. J Pediatr Orthop 1990; 10: 705-12.

  25. Kay S, Smith C, Oppenheim WL. Both bone midshaft forearm fractures in children. J Pediatr Orthop 1986; 6: 306-10.

  26. Kesemenli, CC, Subasi M, Arslan H, Tuzuner T, Necmioglu S, Kapukaya A. Is external fixation in pediatric femoral fractures a risk factor for refracture? Journal of Pediatric Orthopedics 2004; 24(1): 17-20.

  27. Tarr RR, Garfinkel AI, Sarmiento A. The effect of angular and rotational deformities of both bones of the forearm. J Bone Joint Surg [Am] 1984; 66: 65-70.

  28. Blasier RD, Salamon PB. Pediatric adolescent forearm fractures. Oper Tech Orthop 1993; 3: 128-33.

  29. Klasson SC, Blasier RD. Open pediatric forearm fractures in children: ten-year experience. Orthop Trans 1995; 19: 235.

  30. Roy DR, Crawford AH. Operative management of fractures of the shaft of the radius and ulna. Orthop Clin North Am 1990; 21: 245-50.

  31. Chapman MW, Gordon JE, Zissimos A. Compression-plate fixation of acute fractures of the diaphyses of the radius and ulna. J Bone Joint Surg [Am] 1989; 71: 159-69.

  32. Amit Y, Salai M, Chechik A, Blankstein A, Horoszowski H. Closing intramedullary nailing for the treatment of diaphyseal forearm fractures in adolescence: a preliminary report. J Pediatr Orthop 1985; 5: 143-6.

  33. Daruwalla JS. A study of radioulnar movements following fractures of the forearm in children. Clin Orthop 1979; 138: 114-20.

  34. Langkamer V, Ackroyd C. Removal of forearm plates: a review of complications. J Bone Joint Surg [Br] 1990; 72: 601-4.

  35. Rumball K, Finnegan M. Refractures after forearm plate removal. J Orthop Trauma 1990; 4: 124-9.

  36. Vince KG, Miller JE. Cross-union complicating fracture of the forearm. J Bone Joint Surg [Am] 1987; 69: 654-61.

  37. Narayanan UG, Hyman JE, Wainwright AM, Rang M, Alman BA. Complications of elastic stable intramedullary nail fixation of pediatric femoral fractures, and how to Avoid Them. Journal of Pediatric Orthopedics 2004; 24(4): 363-369.

  38. Gates NT, Ouweleen KM, Beebe AC. Intramedullary fixation of unstable forearm fractures in children. Orthop Trans 1995; 19: 116.

  39. Prevot J, Lascombes P, Guichet JM. Elastic stable intramedullary nailing of forearm fractures in children and adolescents. Orthop Trans 1995; 20: 305.

  40. Stanley EA, Wilkins KE. Treatment of midshaft fractures of the radius and ulna utilizing percutaneous intramedullary pinning. Ortho Trans 1995; 20: 305.

  41. Schemitsch EH, Jones D, Henley MB, Tencer AF. A comparison of malreduction after plate fixation and intramedullary nail fixation of forearm fractures. J Orthop Trauma 1995; 9: 8-16.

  42. Lascombes P, Prevot J, Ligier JN, Metaizeau JP, Poncelet T. Elastic stable intramedullary nailing in forearm shaft fractures in children: 85 cases. J Pediatr Orthop 1990; 10: 167-71.

  43. Creaseman C, Zaleske DJ, Ehrlich MG. Analyzing forearm fractures in children: the more subtle signs of impending problems. Clin Orthop 1984; 188: 40-53.

  44. Greenbaum B, Zionts LE, Ebramzadeh E. Open fractures of the forearm in children. J Orthop Trauma 2001; 15: 111-118.

  45. Ortega R, Loder RT, Louis DS. Open reduction and internal fixation of forearm fractures in children. J Pediatr Orthop 1996; 16: 651-654.

  46. Luhmann SJ, Gordon JE, Schoenecker PL. Intramedullary fixation of unstable both-bone forearm fractures in children. J Pediatr Orthop 1998; 18: 451-456.

  47. Van der Reis WL, Otsuka NY, Moroz P et al. Intramedullary nailing versus plate fixation for unstable forearm fractures in children. J Pediatr Orthop 1998; 18: 9-13.

  48. Cullen MC, Roy DR, Giza E et al. Complications of intramedullary fixation of pediatric forearm fractures. J Pediatr Orthop 1998; 18: 14-21.

  49. Haasbeek JF, Cole WG. Open fractures of the arm in children. J Bone Joint Surg [Br] 1995; 77: 576-581.

  50. Stern PJ, Drury WJ. Complications of plate fixation of forearm fractures. Clin Orthop 1983; 175: 25-29.

  51. Wyrsch B, Mencio GA, Green NE. Open reduction and internal fixation of pediatric forearm fractures. J Pediatr Orthop 1996; 16: 644-650.

  52. Kasser JR, Beaty JH. Femoral shaft fractures. In: Beaty JH, Kasser JR, editors. Rockwood and Wilkins’ fractures in children. 5th ed. Philadelphia: Lippincott Williams and Wilkins; 2001. p. 941-80.

  53. Flynn JM, Skaggs D, Sponseller PD, Ganley TJ, Kay RM, Leitch KK. The operative management of pediatric fractures of the lower extremity. J Bone Joint Surg Am 2002; 84: 2288-300.

  54. Stans AA, Morrissy RT, Renwick SE. Femoral shaft fracture treatment in patients age 6 to 16 years. J Pediatr Orthop 1999; 19: 222-8.

  55. Sanders JO, Browne RH, Mooney JF, Raney EM, Horn BD, Anderson DJ, Hennrikus WL, Robertson WW. Treatment of femoral fractures in children by pediatric orthopedists: results of a 1998 survey. J Pediatr Orthop 2001; 21: 436-41.

  56. Martinez AG, Carroll NC, Sarwark JF, Dias LS, Kelikian AS, Sisson GA Jr. Femoral shaft fractures in children treated with early spica cast. J Pediatr Orthop 1991; 11: 712-6.

  57. Aronson DD, Singer RM, Higgins RF. Skeletal traction for fractures of the femoral shaft in children. J Bone Joint Surg Am 1986; 69: 1435-9.

  58. Buehler KC, Thompson JD, Sponseller PD et al. A prospective study of early spica casting outcomes in the treatment of femoral shaft fractures in children. J Pediatr Orthop 1995; 15: 30-5.

  59. Weiss APC, Schenck RC, Sponseller PD et al. Peroneal nerve palsy after early cast application for femoral fractures in children. J Pediatr Orthop 1992; 12: 25-8.

  60. VT. External skeletal fixation in children’s fractures. J Pediatr Orthop 1993; 3: 435-42.

  61. Ziv I, Rang M. Treatment of femoral fractures in the child with head injury. J Bone Joint Surg Br 1983; 65: 276-8.

  62. Reeves RB, Ballard RI, Hughes JL. Internal fixation versus traction and casting of adolescent femoral shaft fractures. J Pediatr Orthop 1990; 10: 592-5.

  63. Conway B. The effect of hospitalization on adolescence. Adolescence 1971; 6: 77.

  64. Hughes BF, Sponseller PD, Thompson JD. Pediatric femur fractures: effects of spica cast treatment on family and community. J Pediatr Orthop 1995; 15: 457-60.

  65. Aronson J, Tursky EA. External fixation of femur fractures in children. J Pediatr Orthop 1992; 12: 157-63.

  66. R, Lindsey RW, Hadley NA et al. Refracture of adolescent femoral shaft fractures: a complication of external fixation: a report of two cases. J Pediatr Orthop 1993; 13: 102-5.

  67. Herndon WA, Mahnken RF, Yngve DA et al. Management of femoral shaft fractures in the adolescent. J Pediatr Orthop 1989; 9: 29-32.

  68. Beaty JH. Aseptic necrosis of the femoral head following antegrade nailing of femoral fractures in adolescents. Tech Orthop 1998; 13: 96-9.

  69. O’Malley DE, Mazur JM, Cummings RJ. Femoral head avascular necrosis associated with intramedullary nailing in an adolescent. J Pediatr Orthop 1995; 15: 21-3.

  70. Gonzalez-Herranz P, Burgos-Flores J, Rapariz JM et al. Intramedullary nailing of the femur in children. J Bone Joint Surg Br 1995; 77: 262-6.

  71. Hierholzer S, Hierholzer G, eds. Internal fixation and metal allergy. In: Clinical investigations, immunology and histology of the implant tissue interface. New York: Georg Thieme Verlag, 1992: 5-7.

  72. Alonso JF, Horowitz M: Use of the AO/ASIF external fixator in children. J Pediatr Orthop 1987; 7: 594-600.

  73. Kirby RM, Winquist RA, Hansen ST. Femoral shaft fracture in adolescents: A comparison between traction plus cast treatment and closed intramedullary nailing. J Pediatr Orthop 1981; 1: 193-197.

  74. Tolo VT. External skeletal fixation in children’s fractures. J Pediatr Orthop 1983; 3: 435-442.

  75. Bar-on E, Sagiv S, Porat S. External fixation or flexible intramedullary nailing for femoral shaft fractures in children. J Bone Joint Surg 1997; 79B: 975-978.

  76. Blasier RD, Aronson J, Tursky EA. External fixation of pediatric femur fractures. J Pediatr Orthop 1997; 17: 342-245.

  77. Davis TJ, Topping RE, Blanco JS. External fixation of pediatric femoral fractures. Clin Orthop 1995; 318: 191-198.

  78. Hull JB, Sanderson PL, Rickman M et al. External fixation of children’s fractures: Use of the orthofix dynamic axial fixator. J Pediatr Orthop 1997; 6: 203-206.

  79. Gregory P, Pevny T, Teague D. Early complications with external fixation of pediatric femoral shaft fractures. J Orthop Trauma 1996; 10: 191-198.

  80. Kregor PJ, Song K, Routt ML, Sangeorzan B. Plate fixation of femoral shaft fractures in multiply injured children. J Bone Joint Surg 1993; 75A: 1774-1780.

  81. Ward TW, Levy J, Kaye A. Compression plating for child and adolescent femur fractures. J Pediatr Orthop 1992; 12: 626-632.

  82. Neer CSII, Francis KC, Marcove RC, Terz J, Carbonara PN. Treatment of unicameral bone cyst. A follow-up study of one hundred seventy-five cases. J Bone Joint Surg 1966; 48-A: 731-745.

  83. Oppenheim WL, Galleno H. Operative treatment versus steroid injection in the management of unicameral bone cyst. J Pediat Orthop 1984; 4: 1-7.

  84. Spence KFJr, Bright RW, Fitzgerald SP, Sell KW. Solitary unicameral bone cyst: treatment with freeze-dried crushed cortical-bone allograft. A review of one hundred and forty-four cases. J Bone Joint Surg 1976; 58-A: 636-641.

  85. Beyer W, Mau H, Lorenz C. Die Anwendung von homologen Spongiosachips bei der Behandlung juveniler Knochenzysten. Beitr Orthop Traumat 1990; 37: 466-467.

  86. Inoue O, Ibaraki K, Shimabukuro H, Shingaki Y. Packing with high-porosity hydroxyapatite cubes alone for the treatment of simple bone cyst. Clin Orthop 1993; 293: 287-292.

  87. Schreuder HW, Conrad EU III, Bruckner JD, Howlett AT, Sorensen L. S. Treatment of simple bone cysts in children with curettage and cryosurgery. J Pediat Orthop 1997; 17: 814-820.

  88. Chigira M, Watanabe H, Arita S, Udagawa E. [Simple bone cyst - pathophysiology and treatment]. Nippon Seikeigeka Gakkai Zasshi 1983; 57: 759-766.

  89. Kuboyama K, Shido T, Harada A, Yokoe S. Therapy of solitary unicameral bone cyst with percutaneous trepination. Rinsho Seikei Geka 1981; 16: 288-293.

  90. Shinozaki T, Arita S, Watanabe H, Chigira M. Simple bone cysts treated by multiple drill-holes. Twenty three cysts followed 2-10 years. Acta Orthop Scandinavica 1996; 67: 288-290.

  91. Hashemi-Nejad A, Cole WG. Incomplete healing of simple bone cysts after steroid injections. J Bone and Joint Surg 1997; 79-B(5): 727-730.

  92. Scaglietti O, Marchetti PG, Bartolozzi P. The effects of methylprednisolone acetate in the treatment of bone cysts. Results of three years follow-up. J Bone Joint Surg 1979; 61-B(2): 200-204.

  93. Lokiec F, Ezra E, Khermosh O, Wientroub S. Simple bone cysts treated by percutaneous autologous marrow grafting. A preliminary report. J Bone Joint Surg 1996; 78-B(6): 934-937.

  94. Yandow SM, Lundeen GA, Scott SM, Coffin C. Autogenic bone marrow injections as a treatment for simple bone cyst. J Pediat Orthop 1998; 18: 616-620.

  95. Santori FS, Ghera S, Castelli V, Tollis A. Dynamic endomedullary nailing in the treatment of extensive bone cysts in young patients. A pathogenetic interpretation. Italian J Orthop Traumatol 1986; 12: 411-417.

  96. Santori F, Ghera S, Castelli V. Treatment of solitary bone cysts with intramedullary nailing. Orthopedics 1988; 11: 873-878.

  97. Cohen J. Unicameral bone cysts. A current synthesis of reported cases. Orthop Clin North America 1977; 8: 715-736.

  98. Heinrich SD. Fractures of the shaft of the tibia and fibula. In: Beaty JH, Kasser JR, editors. Rockwood and Wilkins’ fractures in children. 5th ed. Philadelphia: Lippincott Williams and Wilkins; 2001. p. 1077-119.

  99. RN, Beaty JH, Devito DP, Kasser JR, Loder RT, Rab GT. Operative management of lower extremity fractures in children. Park Ridge: American Academy of Orthopaedic Surgeons; 1992.

  100. Canale ST, Beaty JH. Operative pediatric orthopaedics. 2nd ed. St. Louis: Mosby-Year Book: 1995.

  101. Cullen MC, Roy DR, Crawford AH, Assenmacher J, Levy MS, Wen D. Open fracture of the tibia in children. J Bone Joint Surg Am 1996; 78: 1039-47.




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