CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2019; 54(05): 503-508
DOI: 10.1055/s-0039-1693742
Artigo Original | Original Article
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revnter Publicações Ltda Rio de Janeiro, Brazil

Intramedullary Flexible Nailing for Diaphyseal Fractures of Forearm Bones in Children[*]

Article in several languages: português | English
Balakrishnan M. Acharya
1  Departamento de Ortopedia e Cirurgia do Trauma, Patan Academy of Health Sciences, Patan Hospital, Lalitpur, Nepal
,
1  Departamento de Ortopedia e Cirurgia do Trauma, Patan Academy of Health Sciences, Patan Hospital, Lalitpur, Nepal
,
Abhishek K. Thakur
1  Departamento de Ortopedia e Cirurgia do Trauma, Patan Academy of Health Sciences, Patan Hospital, Lalitpur, Nepal
,
Bidur Gyawali
1  Departamento de Ortopedia e Cirurgia do Trauma, Patan Academy of Health Sciences, Patan Hospital, Lalitpur, Nepal
› Author Affiliations
Further Information

Publication History

25 December 2018

13 May 2019

Publication Date:
27 August 2019 (online)

Abstract

Objectives Most of the fractures of the bones of the forearm in children are successfully treated conservatively with closed reduction and casting. The outcomes remain variable and the patients may require additional fracture manipulation or formal surgical intervention due to residual angulations. The present study assesses the radiological and functional outcomes of treating displaced forearm fractures in children with intramedullary flexible titanium elastic nailing.

Methods A total of 31 patients aged between 7 and 15 years old with displaced forearm fractures underwent flexible titanium elastic nailing. The patients were followed-up for a mean period of 8.51 months (range: 6–12 months) and were assessed for radiological and functional outcomes. The Price criteria were used to assess the functional outcome.

Results Out of 31 patients, 21 patients underwent closed reduction, and 10 required a minimal opening of the fracture site during reduction. A total of 29 patients had excellent results with normal forearm and elbow range of motion (ROM), and 2 patients had good results. In all patients, good radiological union was seen at an average time of 7.9 weeks. Five patients had minor complications, such as skin irritation over the prominent ulnar nail (n = 2), superficial nail insertion site infection (n = 2), and backing out of the ulnar nail (n = 1), requiring early removal.

Conclusion Flexible nailing is an efficient application of internal fixation for shaft fractures of both bones of the forearm in children, enabling early mobilization and return to the normal activities of the patients, with low and manageable complications.

* Study conducted at the Department of Orthopaedics and Trauma Surgery, Patan Academy of Health Sciences, Patan Hospital, Lalitpur, Nepal.