Published online Apr 30, 2008.
https://doi.org/10.12671/jkfs.2008.21.2.169
Minimally Invasive Plate Osteosynthesis in Pediatric Femoral Fractures: What is an Optimal Treatment in a Femoral Fracture of 11 Years-old
Fig. 1
A femoral shaft fracture with a butterfly fragment in 11 years-old girl.
Fig. 2
When flexible nails are remained too long distally, they will protrude the skin and soft tissue (arrow) and it provokes the infection and knee stiffness.
Fig. 3
Although the femoral fracture was well reduced by flexible nails (left), the nails were bent and varus deformity occurred because the patient had a weight-bearing too early (right).
Fig. 4
After the rigid interlocking nailing of femoral shaft fracture in an adolescent, an osteonecrosis of the femoral head occurred (arrow). This picture was from the courtesy of Dr. Byun Young-Soo in Daegu Fatima Hospital.
Fig. 5
These are the sequence of operatingprocedure in the suggested patient of Fig. 1. After the temporary reduction of femoral fracture with flexible nails, the plate was introduced through the submuscular tunnel. Then, the locking screws were fixed at the proximal and distal sides of the plate. The fracture site was not open to preserve the biology. The flexible nail makes an easier reduction of fracture, which facilitates the minimally invasive plate osteosynthesis (MIPO) procedure.
Fig. 6
In postoperative films (left), a satisfactory reduction was achieved. The patient had a solid union, on 1 year follow-up films (right).
Fig. 7
A proximal femoral fracture in 7 years-old boy. In this fracture, the proximal fragment usually abducts and rotated externally. It makes the reduction very difficult. In the past, open reduction with the plate was commonly used.
Fig. 8
With flexible nails, the reduction was achieved. Then, the plate was fixed in the MIPO method.
Fig. 9
In postoperative films (left), a good alignment was achieved. The fracture united at 3 months postoperatively (right).
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