Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Elastic nails help children with broken legs recover faster than traction and body casting

04.05.2004


Elastic titanium nails help children recover faster from a broken leg than the traditional treatment with weeks of traction and a body cast, according to a new study from The Children’s Hospital of Philadelphia. Children with the implanted nails got out of bed within days after surgery, were less dependent on their parents for help in moving, and had fewer complications than children in body casts.



"We’ve shown that although both treatments usually have good outcomes, treatment with elastic nails allows children more rapid mobility and the ability to resume normal daily activities in half the time of the traditional traction and cast treatment," said Jack Flynn, M.D, pediatric orthopaedic surgeon at The Children’s Hospital of Philadelphia and primary investigator of this study. The research team’s study appeared in the April issue of the Journal of Bone and Joint Surgery.

Different than hardware nails, elastic nails are implanted flexible pins that are inserted into the broken bone to support the pieces while the bone heals. The nails are approximately 15 to 20 inches in length and about the width of a radio antenna. Often two nails are necessary for treatment of a fracture. Surgeons remove the nails after the fracture heals, typically six to nine months after surgery.


Since 1996, surgeons in the U.S. have implemented the use of elastic nails more frequently. This is the first prospective study to directly compare the technique to the traditional method of traction and casting. "This study compares the traditional gold standard in the treatment of femur fractures in a prospective way, head-to-head with the newer treatment method of using titanium elastic nails," said Dr. Flynn. "We were looking for a way to get children with femur fractures out of bed and moving as quickly and safely as possible."

The researchers studied 83 children, 6 to 16 years old, treated at The Children’s Hospital of Philadelphia for a fractured femur – the long bone of the thigh. Thirty-five children were treated with traction and a body cast; 48 children were treated with elastic titanium nails. Researchers studied the children for a year following the fracture. All fractures healed and no child sustained a complication that was expected to cause permanent disability.

The study shows that at one year following the fracture, most children who received either treatment had an excellent outcome. The difference is that children who received the elastic nail treatment were able to get out of bed two days after surgery and were discharged from the hospital approximately four days after surgery. Within just a few weeks they were walking with crutches. The children treated with elastic nails missed about half the amount of school as those treated in casts.

Children treated with the traditional method undergo approximately three weeks of traction and then the application of a body cast, which is required for an additional three to five weeks. Casting requires a great commitment of parental involvement, as the child is unable to move on their own during this time. The body cast adds an additional twenty pounds to the child’s weight. The study also shows that the elastic nails decrease the complication rate of the traditional casts.

"The elastic nail method makes the first six months of treatment much more livable for the child and the entire family," says Dr. Flynn. "The newer nail treatment has changed the way we are able to manage the care of these children and the families are very enthusiastic about this option."

Costs for both treatments are similar, but the overall totals were difficult to measure due to numerous factors. The researchers used hospital charges as a proxy for the entire cost of treatment. Other factors such as parents’ time away from work to care for children, rehabilitation costs and well as the charges by varying insurance suppliers make obtaining accurate and complete cost information difficult to quantify.

Physicians were unable to randomize the treatment methods. Instead, the choice of treatment either with traction and application of a body cast or with elastic nails was based on the preference of the attending orthopaedic surgeon.

Elastic nail treatment is usually used in children above 6 years of age. Younger children are typically put in a body cast as their fractures heal much more quickly than older children and adults.

In 1996, titanium elastic nails were used by very few physicians in the U.S. as a treatment of femur fractures, but by the year 2000, the nails became a relatively common treatment option. Physicians from The Children’s Hospital of Philadelphia were instrumental in showing the safety and efficacy of this new treatment model and are widely recognized within the orthopaedic community as innovators of this technique. Femur fractures are the most common major orthopaedic injury in children.

Children’s Hospital sees approximately one child with a femur fracture each week for a total of approximately 40 to 50 each year. Children who range between 6 and 14 years old make up about two-thirds of that population.


###
Dr. Flynn’s co-authors were: Lael M. Luedtke, M.D., of Gilette Children’s Hospital, St. Paul, Minn.; and Theodore J. Ganley, M.D., Judy Dawson. R.N., Richard S. Davidson, M.D., John P. Dormans, M.D., Malcolm L. Ecker, M.D., John R. Gregg, M.D., B. David Horn, M.D., and Denis S. Drummond, M.D., all of the Division of Orthopaedics at The Children’s Hospital of Philadelphia.

Founded in 1855 as the nation’s first pediatric hospital, The Children’s Hospital of Philadelphia is ranked in 2003 as the best pediatric hospital in the nation by U.S.News & World Report and Child magazines. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children’s Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country, ranking second in National Institutes of Health funding among children’s hospitals. In addition, its unique family-centered care and public service programs have brought the 430-bed hospital recognition as a leading advocate for children and adolescents from before birth through age 19. Children’s Hospital operates the largest pediatric healthcare system in the U.S. with more than 40 locations in Pennsylvania, New Jersey and Delaware.

Joey Marie McCool | EurekAlert!
Further information:
http://www.chop.edu/

More articles from Health and Medicine:

nachricht Collagen nanofibrils in mammalian tissues get stronger with exercise
14.12.2018 | University of Illinois College of Engineering

nachricht New discoveries predict ability to forecast dementia from single molecule
12.12.2018 | UT Southwestern Medical Center

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Data storage using individual molecules

Researchers from the University of Basel have reported a new method that allows the physical state of just a few atoms or molecules within a network to be controlled. It is based on the spontaneous self-organization of molecules into extensive networks with pores about one nanometer in size. In the journal ‘small’, the physicists reported on their investigations, which could be of particular importance for the development of new storage devices.

Around the world, researchers are attempting to shrink data storage devices to achieve as large a storage capacity in as small a space as possible. In almost...

Im Focus: Data use draining your battery? Tiny device to speed up memory while also saving power

The more objects we make "smart," from watches to entire buildings, the greater the need for these devices to store and retrieve massive amounts of data quickly without consuming too much power.

Millions of new memory cells could be part of a computer chip and provide that speed and energy savings, thanks to the discovery of a previously unobserved...

Im Focus: An energy-efficient way to stay warm: Sew high-tech heating patches to your clothes

Personal patches could reduce energy waste in buildings, Rutgers-led study says

What if, instead of turning up the thermostat, you could warm up with high-tech, flexible patches sewn into your clothes - while significantly reducing your...

Im Focus: Lethal combination: Drug cocktail turns off the juice to cancer cells

A widely used diabetes medication combined with an antihypertensive drug specifically inhibits tumor growth – this was discovered by researchers from the University of Basel’s Biozentrum two years ago. In a follow-up study, recently published in “Cell Reports”, the scientists report that this drug cocktail induces cancer cell death by switching off their energy supply.

The widely used anti-diabetes drug metformin not only reduces blood sugar but also has an anti-cancer effect. However, the metformin dose commonly used in the...

Im Focus: New Foldable Drone Flies through Narrow Holes in Rescue Missions

A research team from the University of Zurich has developed a new drone that can retract its propeller arms in flight and make itself small to fit through narrow gaps and holes. This is particularly useful when searching for victims of natural disasters.

Inspecting a damaged building after an earthquake or during a fire is exactly the kind of job that human rescuers would like drones to do for them. A flying...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

ICTM Conference 2019: Digitization emerges as an engineering trend for turbomachinery construction

12.12.2018 | Event News

New Plastics Economy Investor Forum - Meeting Point for Innovations

10.12.2018 | Event News

EGU 2019 meeting: Media registration now open

06.12.2018 | Event News

 
Latest News

Pressure tuned magnetism paves the way for novel electronic devices

18.12.2018 | Materials Sciences

New type of low-energy nanolaser that shines in all directions

18.12.2018 | Physics and Astronomy

NASA research reveals Saturn is losing its rings at 'worst-case-scenario' rate

18.12.2018 | Physics and Astronomy

VideoLinks
Science & Research
Overview of more VideoLinks >>>