A study of 50 cases of mangement of non-physeal forearm fracture in children upto the age of 12 years

Author(s): Vishal Mandlewala, Hemant Rathod and Sagar Patel

Abstract: Introduction: Injuries to the shaft of the radius-ulna are the most common reasons for children to receive orthopaedic care and are among the most challenging to the orthopaedist because of their complexity and risk of complications. Diaphyseal fracture of both bones of forearm in mature bone are now treated by open reduction and internal fixation. Diaphyseal fractures of the forearm in children are accounting for 6%-10%. Ninety percentages of them are treated conservatively i.e. closed reduction and plaster casting. The remaining of 10% are irreducible and/or unstable fractures, requiring different treatment methods i.e. closed reduction & casting under general anaesthesia, fixation with pins & plaster casting, closed reduction or mini-invasive Intra-medullary nailing, open reduction & Osteosynthesis with plates & external fixators. Aim and Objectives: To identify the factors such as angulation at fracture site, inclination of epiphyseal plate of radius with the proximal fragments, type of fractures etc. with regards to supination & pronation in the patients treated by closed and open methods. Materials and Methods: This is a prospective study of management of 50 patients having non-physeal fractures of radius-ulna in children upto the age of 12 years. All the patients were treated at the Department of Orthopaedics, GMERS Medical College and Hospital, Valsad, Gujarat from 20/05/2015 to 15/08/2018. The follow-up period ranged from 12 weeks to 30 months. Patients were treated with closed reduction and open reduction internal fixation by Intra-medullary nails i.e. a) Rush nail and Plates i.e. a) 3.5mm DCP b) Reconstruction plate c) 1/3^rd tubular plate. Result: At final follow-up, for closed methods, 90% patients had excellent results & 6.7% patients had good results. For operative method, 88.2% patients for IM nailing & 66.6% patients for plating had excellent results. Conclusion: Close methods is better than operative methods.

DOI: https://doi.org/10.22271/ortho.2018.v4.i4e.45