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Implant removal associated complications after ESIN osteosynthesis in pediatric fractures
PURPOSE: ESIN (elastic stable intramedullary nailing) is considered the gold standard for various pediatric fractures. The aim of this study was to analyze the incidence and type of complications during or after TEN (titanium elastic nail) removal. METHODS: A retrospective data analysis was performe...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9532316/ https://www.ncbi.nlm.nih.gov/pubmed/34338820 http://dx.doi.org/10.1007/s00068-021-01763-4 |
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author | Lieber, Justus Dietzel, Markus Scherer, Simon Schäfer, Jürgen F. Kirschner, Hans-Joachim Fuchs, Jörg |
author_facet | Lieber, Justus Dietzel, Markus Scherer, Simon Schäfer, Jürgen F. Kirschner, Hans-Joachim Fuchs, Jörg |
author_sort | Lieber, Justus |
collection | PubMed |
description | PURPOSE: ESIN (elastic stable intramedullary nailing) is considered the gold standard for various pediatric fractures. The aim of this study was to analyze the incidence and type of complications during or after TEN (titanium elastic nail) removal. METHODS: A retrospective data analysis was performed. Metal removal associated complications and preoperative extraosseous length/outlet angle of TENs as possible causes of complications were assessed. RESULTS: The complication rate in 384 TEN removals was 3.1% (n = 12). One major complication (rupture of M. extensor pollicis brevis) was documented. One refracture at the forearm occurred, however, remodeling prior TEN removal was completed. Ten minor complications were temporary or without irreversible restrictions (3 infections, 5 scaring/granuloma, 2 temporary paraesthesia). In 38 cases (16 forearms, 10 femora, 9 humeri, 3 lower legs), intra-operative fluoroscopy had to be used to locate the implants. In patients with forearm fractures, extraosseous implant length was relatively shorter than in cases without fluoroscopy (p = 0.01), but outlet angle of TENs was not significantly different in these two groups (28.5° vs 25.6°). In patients with femur fractures, extraosseous implant length and outlet angle were tendentially shorter, respectively, lower, but this did not reach statistical significance. CONCLUSION: Removal of TENs after ESIN is a safe procedure with a low complication rate. Technically inaccurate TEN implantation makes removal more difficult and complicated. To prevent an untimely removal and patient discomfort, nail ends must be exactly positioned and cut. Intraoperative complications may be minimized with removal of TENs before signs of overgrowth. EVIDENCE: Level III, retrospective. |
format | Online Article Text |
id | pubmed-9532316 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-95323162022-10-06 Implant removal associated complications after ESIN osteosynthesis in pediatric fractures Lieber, Justus Dietzel, Markus Scherer, Simon Schäfer, Jürgen F. Kirschner, Hans-Joachim Fuchs, Jörg Eur J Trauma Emerg Surg Original Article PURPOSE: ESIN (elastic stable intramedullary nailing) is considered the gold standard for various pediatric fractures. The aim of this study was to analyze the incidence and type of complications during or after TEN (titanium elastic nail) removal. METHODS: A retrospective data analysis was performed. Metal removal associated complications and preoperative extraosseous length/outlet angle of TENs as possible causes of complications were assessed. RESULTS: The complication rate in 384 TEN removals was 3.1% (n = 12). One major complication (rupture of M. extensor pollicis brevis) was documented. One refracture at the forearm occurred, however, remodeling prior TEN removal was completed. Ten minor complications were temporary or without irreversible restrictions (3 infections, 5 scaring/granuloma, 2 temporary paraesthesia). In 38 cases (16 forearms, 10 femora, 9 humeri, 3 lower legs), intra-operative fluoroscopy had to be used to locate the implants. In patients with forearm fractures, extraosseous implant length was relatively shorter than in cases without fluoroscopy (p = 0.01), but outlet angle of TENs was not significantly different in these two groups (28.5° vs 25.6°). In patients with femur fractures, extraosseous implant length and outlet angle were tendentially shorter, respectively, lower, but this did not reach statistical significance. CONCLUSION: Removal of TENs after ESIN is a safe procedure with a low complication rate. Technically inaccurate TEN implantation makes removal more difficult and complicated. To prevent an untimely removal and patient discomfort, nail ends must be exactly positioned and cut. Intraoperative complications may be minimized with removal of TENs before signs of overgrowth. EVIDENCE: Level III, retrospective. Springer Berlin Heidelberg 2021-08-02 2022 /pmc/articles/PMC9532316/ /pubmed/34338820 http://dx.doi.org/10.1007/s00068-021-01763-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Lieber, Justus Dietzel, Markus Scherer, Simon Schäfer, Jürgen F. Kirschner, Hans-Joachim Fuchs, Jörg Implant removal associated complications after ESIN osteosynthesis in pediatric fractures |
title | Implant removal associated complications after ESIN osteosynthesis in pediatric fractures |
title_full | Implant removal associated complications after ESIN osteosynthesis in pediatric fractures |
title_fullStr | Implant removal associated complications after ESIN osteosynthesis in pediatric fractures |
title_full_unstemmed | Implant removal associated complications after ESIN osteosynthesis in pediatric fractures |
title_short | Implant removal associated complications after ESIN osteosynthesis in pediatric fractures |
title_sort | implant removal associated complications after esin osteosynthesis in pediatric fractures |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9532316/ https://www.ncbi.nlm.nih.gov/pubmed/34338820 http://dx.doi.org/10.1007/s00068-021-01763-4 |
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