International Journal of Orthopaedics Sciences

Elastic intramedullary nailing in paediatric diaphyseal both bone forearm fractures

2020, Volume 6 Issue 4

Elastic intramedullary nailing in paediatric diaphyseal both bone forearm fractures

Author(s): Dr. Pawan Kumar and Dr. Arun Kumar Naik
Abstract: 
Both bone forearm fractures are prevalent orthopaedic injuries. Optimal treatment in paediatric population remains conservative management with closed reduction and immobilization with above elbow cast application. Although fracture unites readily with acceptable alignment due to structural realignment owing to its ability to remodel with remaining growth, malunion is very common. Stiffness of joints and compartment syndrome are other complications with conservative management. Irreducible, unstable, and open fractures usually require operative stabilization with K wires, Plate and screws, or intramedullary nailing. Plating has the advantage of being familiar to many surgeons and theoretically superior in its ability to restore radial bow with added disadvantages. Recently intramedullary nailing has changed the treatment scenario of diaphyseal both bone fractures in the children and adolescents.
The study aims to analyze the outcome and complications after elastic stable intramedullary nailing in paediatric diaphyseal forearm fractures.
Material and methods: Our series present 23 patients aged 5-15 years with displaced both bone forearm fractures with closed reduction and elastic stable intramedullary nailing under the C arm image intensifier. Among 23 patients, 15 patients were males, and 8 were females with a mean age of 11 years having 4 cases as open fractures.
Result: Most of the fractures healed within 5-8 months. We analyzed the results using the reference to union, symptoms, and range of motion of adjacent joints using Price et al. criteria for outcome evaluation. In our series, 18 cases (78.26%) had excellent, 3(13.04%) cases had good, 1(4.34%) case had fair, and 1(4.34%) had poor result due to delayed union. There was one case of delayed union, one case of transient palsies of the superficial radial nerve and 1 case with skin irritation over prominent ulnar hardware requiring early removal and infection in external nail insertion site in Radius in 1 patient and one case of tendon injury. At the final follow up after 8-9 months, we did implant removal with pain-free and without limitation of ADL.
Conclusion: One can achieve better functional and cosmetic outcomes by elastic stable intramedullary nailing. It is simple, cost-effective, less time consuming and having fewer complications.
Pages: 446-450  |  611 Views  60 Downloads
How to cite this article:
Dr. Pawan Kumar, Dr. Arun Kumar Naik. Elastic intramedullary nailing in paediatric diaphyseal both bone forearm fractures. Int J Orthop Sci 2020;6(4):446-450. DOI: 10.22271/ortho.2020.v6.i4g.2369
 
International Journal of Orthopaedics Sciences
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