Clinical case for the use of intramedullary osteosynthesis in the treatment of pathological fractures of the femur in 6-day newborn girls with a high partial intestinal obstruction

Evgeny G. Skryabin; Maxim A. Sorokin; Mikhail A. Akselrov; Viktoria A. Emelyanova; Sergey V. Naumov; Alexander N. Bukseev; Alexander Y. Chuprov

doi:10.17816/PTORS5252-58

Pediatric Traumatology, Orthopaedics and Reconstructive Surgery ›› 2017, Vol. 5 ›› Issue (2) : 52 -58. DOI: 10.17816/PTORS5252-58

Articles

research-article

Clinical case for the use of intramedullary osteosynthesis in the treatment of pathological fractures of the femur in 6-day newborn girls with a high partial intestinal obstruction

Author information +

Tyumen State Medical University

Regional clinical hospital No 2

MD, PhD, professor of the Department of Traumatology and Orthopedics with the course of children’s traumatology

MD, resident physician of the traumatologic and orthopedic department of the children’s department

MD, PhD, Head of the Department of Pediatric Surgery, Head of the surgical department of the children’s department

MD, neonatologist of intensive care unit of newborns

MD, the head of the traumatologic and orthopedic department of the children’s department

MD, resident physician of the traumatologic and orthopedic department of the children’s department

Show less

History +

PDF (824KB)

Abstract

Abstract. Skeletal bone fractures in newborns present a problem of modern traumatology.

Aim. The goal is to present the use of the method of intramedullary osteosynthesis in the treatment of a pathological fracture of the right femur in a newborn girl to a wide audience of pediatric orthopedic traumatologists.

Material and methods. We have experience in the treatment of a 6-day-old girl, who was born with intrauterine growth retardation and bowel disease. On the second day of stay in the intensive care unit, she had a pathological fracture of the right femur. Diagnosis of the pathological fracture was established based upon the results of clinical examination and radiography of the injured limb segment.

Results. Immediately after the diagnosis, the right lower limb of the child was fixed with a plaster bandage. On the control radiographs, the standing of the bone fragments were unsatisfactory, and a decision was made to use the intramedullary osteosynthesis method with a knitting needle on the 6th day after birth of the child. The need for surgical treatment of a fracture of the femur was due to a congenital abnormality of the intestine in the child, and a need to perform surgery on the abdominal organs.

Discussion. Spontaneous fracture of the right femur occurred in the child in treatment in the intensive care unit. The cause of the fracture was osteopenic syndrome, which developed as a result of vitamin D deficiency. During the first 12 days of her life, the newborn had two laparoscopic operations to address the intestinal pathology.

Four weeks after the operation using osteosynthesis, the metal from the bone marrow channel of the right femur was removed. After the removal of the needle, the correct axis of the operated segment was fixed to the same length of the lower extremities. The patient had absence of pathological mobility in the fracture region, and full amplitude of movements in the knee and hip joints.

Conclusion. When receiving fractures of the femur, both traditionally used conservative methods of treatment, as well as surgical methods can be used on newborn children. This is especially true, when a newborn has an accompanying congenital pathology of the internal organs requiring immediate treatment.

Keywords

newborn child / pathological fracture / femur / intramedullary osteosynthesis / intestinal obstruction

Cite this article

Download citation ▾

Evgeny G. Skryabin, Maxim A. Sorokin, Mikhail A. Akselrov, Viktoria A. Emelyanova, Sergey V. Naumov, Alexander N. Bukseev, Alexander Y. Chuprov. Clinical case for the use of intramedullary osteosynthesis in the treatment of pathological fractures of the femur in 6-day newborn girls with a high partial intestinal obstruction. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 2017, 5(2): 52-58 DOI:10.17816/PTORS5252-58

登录浏览全文

4963

注册一个新账户忘记密码

References

Publishing order | Descend order by publishing year | Descend order by cited within

[1]	1.Шабалов Н.П. Неонатология. – М.: МЕДпресс-информ, 2004. [Shabalov NP. Neonatologiya. Moscow: MEDpress-inform; 2004. (In Russ.)]

[2]	2.Mbouto-Mandavo C, N'dour O, Ouedraogo SF. Newborn and infant secondary to traditional massage. Arch. Pediatr. 2016;23(9):963-965. doi: 10.1016/j.arcped.2016.04.024.

[3]	3.Исаков Ю.Ф. Детская хирургия. – М.: Медицина, 1983. [Isakov YuF. Detskaya khirurgiya. Moscow: Meditsina; 1983. (In Russ.)]

[4]	4.Gill KG. Pediatric hip: pearls and pitfalls. Semin. Musculoskeletal Radiol. 2013;17(3):328-338. doi: 10.1055/s-003301348099.

[5]	5.Sankar WN, Weiss J, Skaggs DL. Orthopedic conditions in the newborn. J Am Acad Orthop Surg. 2009;17(2):112-122. doi: 10.5435/00124635-200902000-00007.

[6]	6.Уотсон-Джон Р. Переломы костей и повреждения суставов (пер. с англ.). – М.: Медицина, 1972. [Uotson-Dzhon R. Perelomy kostey i povrezhdeniya sustavov (per. s angl.). Moscow: Meditsina; 1972. (In Russ.)]

[7]	7.Ruch JK, Kelly DM, Sawyer JR. Treatment of pediatric femur fractures with the Pavlik harness: multiyear clinical and radiographic outcomes. J Pediatr Orthop. 2013;33(6):614-617. doi: 10.1097/BPO.ob013e318292464a.

[8]	8.Blount WP, Schultz J, Cassidy R. Fractures of the elbow in children. JAMA. 1954;146:699-702. doi:10.1001/jama.1951.03670080007002.

[9]	9.Ормантаев К.С., Марков Р.Ф. Детская травматология. – Алма-Ата: Казахстан, 1978. [Ormantaev KS, Markov RF. Detskaya travmatologiya. Alma-Ata: Kazakhstan; 1978. (In Russ.)]

[10]

10.Юхнова О.М., Пономарева Г.А. Клиника, диагностика, лечение и профилактика интранатальных повреждений костей конечностей у новорожденных. – Тюмень, 1990. [Yukhnova OM, Ponomareva GA. Klinika, diagnostika, lechenie i profilaktika intranatal’nykh povrezhdeniy kostey konechnostey u novorozhdennykh. Tyumen; 1990. (In Russ.)]

[11]

11.Верещакина О.А., Залетина А.В., Кенис В.М. Влияние уровня витамина D в перинатальном периоде на состояние здоровья // Ортопедия, травматология и восстановительная хирургия детского возраста. – 2015. – Т. 3. – № 4. – С. 60–65. [Vereshchakina OA, Zaletina AV, Kenis VM. Effect of vitamin D on the health status in the perinatal period. Ortopediya, travmatologiya i vosstanovitel’naya khirurgiya detskogo vozrasta. 2015;3(4):60-65. (In Russ.)] doi: 10.17816/PTORS3460-65.

[12]	12.Machado A, Rocha G, Silva A. Bone fractures in a neonatal intensive care unit. Acta Med Port. 2015;28(2):204-208. doi: 10.20344/amp.5660.

[13]

13.Воротынцева Н.С., Воротынцев С.Г., Новикова А.Д. Ранняя рентгенодиагностика остеопении у недоношенных новорожденных детей // Юбилейный конгресс российского общества рентгенологов и радиологов: Материалы конгресса. – СПб., 07-09 ноября 2016. – С.49. [Vorotyntseva NS, Vorotyntsev SG, Novikova AD. Rannyaya rentgenodiagnostika osteopenii u nedonoshennykh novorozhdennykh detey. Yubileynyy kongress rossiyskogo obshchestva rentgenologov i radiologov (conference proceedings). 2016 nov 07-09; Saint Peterburg (In Russ.)] Доступно по: http://congress-ph.ru/istorija_1_1/2016/rar16. Ссылка активна на 08.03.2017.

[14]	14.Strohm PC, Schmittenbecher PP. Femoral shaft fractures in children under 3 yeares old. Current treatment standard Unfallchirurg. 2015;118(1):48-52. doi: 10.1007/s00113-014-2639-7.