Frakres pedijatrijskih podlaktica, Posebno mjelo dijafejnih prijeloma koji uključuju radijus i ulnu, su među najčešćim ortopedskim ozljedama kod djece, računovodstvo 13% do 40% of all pediatric fractures. While the majority of these fractures can be managed conservatively with closed reduction and casting, certain cases—such as unstable, open, or irreducible fractures—necessitate surgical intervention. In such scenarios, intramedullary fixation using stainless steel Rush pins offers a minimally invasive, effective, and economical alternative, especially in resource-limited settings.
Origins and Indications of Rush Pins
The Rush pin was developed in the 1930s by Dr. Leslie Rush, an American surgeon who pioneered the technique of internal bone fixation. His innovation led to the creation of the Rush pin, a flexible intramedullary nail designed to stabilize long bone fractures.
Rush pins are particularly indicated for pediatric diaphyseal forearm fractures that are unstable, open, or irreducible. They are also suitable for cases where conservative management has failed or is likely to fail. The pins are inserted intramedullary, providing internal support while preserving the periosteal blood supply and minimizing soft tissue disruption.
Advantages of Using Stainless Steel Rush Pins
Minimalno invazivna tehnika: Umetanje Rush igle zahtijeva male rezove, što dovodi do smanjene kirurške traume i boljih kozmetičkih rezultata.
Isplativost: U poređenju sa titanijumskim elastičnim ekserima, Rush igle od nehrđajućeg čelika su pristupačnije i široko dostupne, što ih čini idealnim izborom u zemljama u razvoju.
Efektivna stabilizacija: Raš igle pružaju adekvatnu stabilizaciju za dijafizne frakture, promoviranje odgovarajućeg usklađivanja i olakšavanje rane mobilizacije.
Jednostavnost uklanjanja: Dizajn Rush klinova omogućava jednostavno uklanjanje nakon što prijelom zacijeli, obično bez potrebe za opsežnom hirurškom intervencijom.
Niske stope komplikacija: Studije su pokazale da upotreba Rush iglica kod pedijatrijskih prijeloma podlaktice rezultira visokim stopama spajanja prijeloma i malom učestalošću komplikacija.
Clinical Outcomes
Clinical studies have demonstrated the efficacy of Rush pins in managing pediatric diaphyseal forearm fractures. In a study conducted in Nepal, 30 children treated with intramedullary Rush pins achieved fracture union in an average of 6.5 weeks, with 83.3% attaining excellent results and 16.6% good results. Another study involving 50 pediatric patients reported that 94% achieved excellent outcomes, with all fractures maintaining good alignment post-operatively and radiological union observed within three months.
Zaključak
Stainless steel Rush pins offer a reliable, cost-effective, and minimally invasive option for the surgical management of pediatric diaphyseal forearm fractures. Their ease of use, affordability, and favorable clinical outcomes make them particularly valuable in settings where resources are limited. As such, Rush pins remain a pertinent choice in the orthopedic treatment arsenal for pediatric forearm fractures.