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Cortical erosion after elastic stable intramedullary nail fixation for pediatric long bone fractures: Case series according to the site

Authors
 Kun-Bo Park  ;  Je-Hyun Yoo  ;  Seok Woo Kim  ;  Yoon Hae Kwak 
Citation
 International Journal of Surgery, Vol.55 : 60-65, 2018 
Journal Title
 International Journal of Surgery 
ISSN
 1743-9191 
Issue Date
2018
MeSH
Bone Diseases/diagnostic imaging* ; Bone Diseases/etiology ; Bone Nails/adverse effects* ; Child ; Cortical Bone/diagnostic imaging ; Cortical Bone/pathology ; Female ; Fracture Fixation, Intramedullary/adverse effects* ; Fractures, Bone/surgery* ; Humans ; Male ; Postoperative Complications/diagnostic imaging* ; Postoperative Complications/etiology ; Postoperative Period ; Radiography
Keywords
Children ; Cortical erosion ; Elastic stable intramedullary nail ; Long bone fracture
Abstract
BACKGROUND: Elastic stable intramedullary nail (ESIN) is widely used for treatment of long bone fractures in children. However, migration of the nail or cortical bone erosion in children has been reported. This study was conducted to investigate the incidence of cortical erosion according to the site and cortical erosion type. MATERIALS AND METHODS: A total of 221 normally developing children (223 fractures) who were treated with ESIN for fractures of the long bones without cortical breakage at immediate postoperative radiography and with the ESIN in position for more than 6 months were included. Two pediatric orthopaedic surgeons reviewed all the radiographs. Cortical bone erosion was defined when the two investigators agreed that there was cortical breakage by the ESIN. RESULTS: Penetration of nails through the bone cortex was observed in 25 patients (11.2%). Fifteen patients (6.7%) showed cortical erosion at the diaphysis and ten patients (4.5%) showed protrusion of the tip of the ESIN at the metaphysis-diaphysis junction. The average time for hardware removal in patients with cortical erosion was 14.2 months. CONCLUSION: Cortical bone erosion by ESIN could occur in pediatric long bones without any iatrogenic problem or disease related to the bony structure. Erosion at diaphysis was more common than at metaphysis-diaphysis junction. Cortical erosion should be considered in children who retain their ESIN for a long time.
Full Text
https://www.sciencedirect.com/science/article/pii/S1743919118307672
DOI
10.1016/j.ijsu.2018.05.020
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Kun Bo(박건보) ORCID logo https://orcid.org/0000-0002-8839-4870
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/170850
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