Abstract: Background: Antebrachium fractures in paediatric age group, which are unstable are more commonly treated nowadays using intramedullary titanium elastic nailing. Recent studies have showed a higher complication rates in adolescent population when compared to the paediatric counterpart. The aim and objective of this study is to compare the complication rates and outcome in paediatric and adolescent population treated using flexible nail.
Methods: An ethical committee approved study was conducted in Rajah Muthiah Medical College, Chidambaram from May 2018 to September 2020 on both bone forearm fractures in paediatric and adolescent population. In our study 20 cases of both bone forearm fractures, of which 10 belonging to paediatric age group (age less than 10 years) and 10 cases belonging to adolescent age group (age more than 10 years) treated with flexible intramedullary nail (TENS). These cases were followed up for period of 1 year and complications were quantified on the basis of Clavien – Dindo classification. Outcomes were analysed based on Martus et al. grading system.
Results: Out of 20 forearm fractures treated with tens nail in each age group, mean age was found to be 13.6 years in adolescent group and 9.2 years in paediatric group. Mean follow up period were42 weeks in adolescent category and 40 weeks in paediatric category. Average time and duration from the point of injury to the surgical procedure was 2 to 3 days in both groups. Closed reduction and internal fixation with tens nailing was done in 13 cases (8 paediatric and 5 adolescent group) and open reduction was needed in the remaining 7 cases (2 paediatric and 5 adolescent). The overall result of our study showed that complications were slightly higher in adolescent age group, when compared to the paediatric counterparts. P value between the two groups was not significant.
Conclusion: Tens nailing is an excellent technique for paediatric and adolescent fractures of forearm with very good functional outcome. Even though complications were seen in adolescent age group, it was significantly lower than those associated with other surgical techniques. However, with lesser complication rate in paediatric age group, we conclude that in fractures requiring surgical fixation, TENS nailing is more advantageous than other surgical options.
