The surgery outcomes of pediatric femoral shaft fractures and comparision of radiation risks
Keywords:
Pediatric femoral fractures, radiation risk ,canser risk.Abstract
Introduction: To show midterm results and compare the two methods utilized in pediatric femoral diaphysis fractures fixation and the risks of radiation. Methods: We conducted retrospective studies of 60 children and adolescent between the age of 6 to 16 years who were exposed to traumatic femoral shaft fractures and treated with methods of fixation titanyum elastic nail (EN), submuscular bridge plating (SBP) Twenty eight (18 males and 10 females) were treated with SBP (group 1), and 32 patients (18 males and 14 females) were treated with EN (group 2). Results: The mean age of the patients was 10,3 years. Duration of follow-up was 29.8 months. Mean union time was 7,4 weeks (range, 6-10 weeks). Operative time was on average 60.6 minutes. Considering Flynn’s criteria, the results of treatment was excellent in 50, good in 4 and poor in 6 cases. Conclusions: In the surgical treatment of pediatric femoral shaft fractures, fixation techniques such as submuscular bridge platingand elastic nails were found to have similar fracture healing and complication rates. An orthopaedic surgeon must protect himself, his personnel and the patient from radiation exposure. Open reduction internal plate fixation can be chosen as an alternative treatment for children who do not cause radiation exposure to the femoral fracture.
References
O'Rourke PJ, Crerand S, Harrington P, Casey M, Quinlan W. Risks of radiation exposure to orthopaedic surgeons. J R Coll Surg Edinb. 1996;(41):40–3
JK Jain, RK Sen, SC Bansal, ON Nagi. Image intensifier and the orthopedic surgeon. Ind J Orthop. 2001;35(2):13–9
Bindal RK, Glaze S, Ognoskie M, Tunner V, Malone R, Ghosh S. Surgeon and patient radiation exposure in minimally invasive transforaminal lumbar interbody fusion. J Neurosurg Spine. 2008;(9):570-573
Le Heron JC. Estimation of effective dose to the patient during medical x-ray examinations from measurements of the dose-area product. Phys Med Biol 1992;(37):2117–26
Sahlin Y. Occurrence of fractures in a defined population: a 1-year study. Injury. 1990;21(3):158–160
Loder RT, O’Donnell PW, Feinberg JR. Epidemiology and mechanisms of femur fractures in children. J Pediatr Orthop. 2006;(26):561–566
Flynn JM, Luedtke L, Ganley TJ, Pill SG. Titanium elastic nails for pediatric femur fractures: lessons from the learning curve. Am J Orthop. 2002;(31):71–74
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
The recommendations of the International Commission on Radiological Protection. Ann ICRP 2007; 37:1–332. Editor J. VALENTIN. ICRP publication 103
An Evaluation of Radiation Exposure Guidance for Military Operations: Interim Report. 1997. J. Christopher Johnson and Susan Thaul, Editors. National Academy of Sciences. ISBN 0-309-05895-3
Huda W, Greene-Donnelly K. RT x-ray physics review. 2011. Madison, WI: Medical Physics Publishing
Kleinerman RA. Cancer risks following diagnostic and therapeutic radiation exposure in children. Pediatr Radiol. 2006;36:121–125.
Huda W. Kerma-area product in diagnostic radiology. 2014. AJR, 203:[web]W565–W569
Mastrangelo G, Fedeli U, Fadda E, Giovanazzi A, Scoizzato L, Saia B. Increased cancer risk among surgeons in an orthopaedic hospital. Occup Med (Lond) 2005;(55):498–500
Alonso JA, DL Shaw, A Maxwell, McGill GP, Hart GC. Scattered radiation during fixation of hip fractures. Is distance alone enough protection? J Bone Joint Surg Br. 2001;83(6):815–18
N Theocharopoulos, K Perisinakis, J Damilakis, G Papadokostakis, A Hadjipavlou, N Gourtsoyiannis. Occupational exposure from common fluoroscopic projections used in orthopaedic surgery. J Bone Joint Surg Am. 2003;(85):1698–703
Andreassi MG, Ait-Ali L, Botto N, Manfredi S, Mottola G, Picano E. Cardiac catheterization and long-term chromosomal damage in children with congenital heart disease. Eur Heart J. 2006;27:2703–2708
Committee to Assess Health Risks from Exposure to Low Levels of Ionizing Radiation. Nuclear and Radiation Studies Board, Division on Earth and Life Studies. National Research Council of the National Academies . Health Risks from Exposure to Low Levels of Ionizing Radiation: BEIR VII Phase 2. The National Academies Press; Washington, DC: 2006.
UNSCEAR (2000) UNSCEAR 2000. The United Nations Scientific Committee on the Effects of Atomic Radiation. Health Phys 79:314 [PubMed]
Saikia KC, Bhuyan SK, Bhattacharya TD, SP Saikia. Titanium elastic nailing in femoral diaphyseal fractures of children in 6-16 years of age. Indian J Orthop 2007;41(4):381-5
Mann DC, Weddington J, Davenport K. Closed Ender nailing of femoral shaft fractures in adolescents. J Paediatr Orthop 1986;6(6):651-5
Ho CA, Skaggs DL, Tang CW, Kay RM. Use of flexible intramedullary nails in paediatric femur fractures. J Paediatr Orthop 2006;26(4):497-504
Mazda K, Khairouni A, Pennecot GF, et al. Closed flexible intramedullary nailing of the femoral shaft fractures in children. J Paediatr Orthop B 1997;6(3):198-202
Cramer KE, Tornetta P 3rd, Spero CR, Alter S, Miraliakbar H, Teefey J. Ender rod fixation of femoral shaft fractures in children. Clin Orthop Relat Res 2000;(376):119-23
Galpin RD, Willis RB, Sabano N. Intramedullary nailingof paediatric femoral fractures. J Paediar Orthop 1994;14(2):184-9
Moroz LA, Launay F, Kocher MS, Newton PO, Frick SL, Sponseller PD, et al. Titanium elastic nailing of the femur in children: predictors of complications and poor outcomes. J Bone Joint Surg Br. 2006;(88):1361–1366
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