The American journal of orthopedics
-
Comparative Study
Use of flexible intramedullary nail fixation in treating femur fractures in children.
We evaluated use of flexible intramedullary nails in the surgical treatment of femoral shaft fractures in 135 children (138 fractures). Mean age was 9.7 years (range, 2-17 years). Mean follow-up was 15.6 months (range, 6.6-53.5 months). ⋯ Fracture patterns were transverse (66), oblique (42), spiral (24), and comminuted (6). There were 16 complications--3 refractures, 2 delayed unions, 3 varus or valgus malalignments, 5 nail-tip irritations, 2 broken interlocking screws (found incidentally on radiographs), and 1 asymptomatic proximal nail migration--for a complication rate of 11.7%. These results demonstrate that use of flexible intramedullary nails in the treatment of femoral shaft fractures in children is successful regardless of patient age, fracture location, or fracture pattern.
-
Total hip arthroplasty (THA), an effective treatment for patients with end-stage arthritic hip conditions, provides dramatic pain relief, enhances mobility, and restores function. The success of THA in older patients, in concert with improvements in techniques and biomaterials, has stimulated demand for this procedure in younger, more active patients hoping to regain full activity. ⋯ Unfortunately, the value of these studies is limited because of heterogeneous hip pathology in the younger groups, particularly given that preoperative pathology has proved to significantly affect implant survival. In this review of the literature, we focus on THA survival in young, active patients with a preoperative diagnosis of noninflammatory osteoarthritis.