Functional and radiological outcome of both bone fracture forearm in children managed with titanium elastic nailing system

Muhammad Farooq Butt; Saqib Ayaz; Irfan Malik; M. Anwar Ahmed; Zubair Ahmad Lone

doi:10.18203/2320-6012.ijrms20250966

Authors

Muhammad Farooq Butt Department of Orthopedics, Government Medical College, Jammu, Jammu and Kashmir, India
Saqib Ayaz Department of Orthopedics, Government Medical College, Rajouri, Jammu and Kashmir, India
Irfan Malik Department of Orthopedics, Government Medical College, Rajouri, Jammu and Kashmir, India
M. Anwar Ahmed Department of Orthopedics, Government Medical College, Rajouri, Jammu and Kashmir, India
Zubair Ahmad Lone Department of Orthopedics, Government Medical College, Rajouri, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20250966

Keywords:

Forearm fracture, Titanium elastic nailing system, Elastic stable intramedullary nailing

Abstract

Background: Forearm diaphyseal fracture is one of the three common upper limb fractures in the pediatric population. With many known methods of treatment available, the authors present their experience of managing these injuries by titanium elastic nailing system.

Methods: The present study was a prospective study of 3 years duration which included 50 patients. All patients underwent elastic nailing of both radius and ulna in the same sitting. Analysis of pre-operative and post-operative radiographs of forearm, taken in two orthogonal views, was done. Final functional outcome was graded clinically by using criteria laid down by Price et al.

Results: Good to excellent results were achieved after elastic nailing of forearm fractures in all the children. In this study, bony union was achieved in a mean time of 8.36 weeks, range being 6 to 14 weeks. No case of non-union was observed in the present study. Pin tract infection and skin irritation were the most common complication observed.

Conclusions: Elastic stable intramedullary nailing is a safe and reliable method for internal fixation, giving predictably good functional results in paediatric both bone forearm fractures.

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References

Mann DC, Rajmaira S. Distribution of physeal and nonphyseal fractures in 2,650 long-bone fractures in children aged 0-16 years. J Pediatr Orthop. 1990;10(6):713-6. DOI: https://doi.org/10.1097/01241398-199011000-00002

Creasman C, Zaleske DJ, Ehrlich MG. Analyzing forearm fractures in children. The more subtle signs of impending problems. Clin Orthop Relat Res. 1984;(188):40-53. DOI: https://doi.org/10.1097/00003086-198409000-00006

Bowman EN, Mehlman CT, Lindsell CJ, Tamai J. Nonoperative treatment of both-bone forearm shaft fractures in children: predictors of early radiographic failure. J Pediatr Orthop. 2011;31(1):23-32. DOI: https://doi.org/10.1097/BPO.0b013e318203205b

Price CT, Scott DS, Kurzner ME, Flynn JC. Malunited forearm fractures in children. J Pediatr Orthop. 1990;10(6):705-12. DOI: https://doi.org/10.1097/01241398-199011000-00001

Younger AS, Tredwell SJ, Mackenzie WG, Orr JD, King PM, Tennant W. Accurate prediction of outcome after pediatric forearm fracture. J Pediatr Orthop. 1994;14(2):200-6. DOI: https://doi.org/10.1097/01241398-199403000-00013

Flynn JM, Jones KJ, Garner MR, Goebel J. Eleven years experience in the operative management of pediatric forearm fractures. J Pediatr Orthop. 2010;30(4):313-9. DOI: https://doi.org/10.1097/BPO.0b013e3181d98f2c

Lyman A, Wenger D, Landin L. Pediatric diaphyseal forearm fractures: epidemiology and treatment in an urban population during a 10-year period, with special attention to titanium elastic nailing and its complications. J Pediatr Orthop B. 2016;25(5):439-46. DOI: https://doi.org/10.1097/BPB.0000000000000278

Baldwin K, Morrison MJ 3rd, Tomlinson LA, Ramirez R, Flynn JM. Both bone forearm fractures in children and adolescents, which fixation strategy is superior - plates or nails? A systematic review and meta-analysis of observational studies. J Orthop Trauma. 2014;28(1):8-14. DOI: https://doi.org/10.1097/BOT.0b013e31829203ea

Zionts LE, Zalavras CG, Gerhardt MB. Closed treatment of displaced diaphyseal both-bone forearm fractures in older children and adolescents. J Pediatr Orthop. 2005;25(4):507-12. DOI: https://doi.org/10.1097/01.bpo.0000158005.53671.c4

Patel A, Li L, Anand A. Systematic review: functional outcomes and complications of intramedullary nailing versus plate fixation for both-bone diaphyseal forearm fractures in children. Injury. 2014;45(8):1135-43. DOI: https://doi.org/10.1016/j.injury.2014.04.020

Furlan D, Pogorelić Z, Biočić M, Jurić I, Budimir D, Todorić J, et al. Elastic stable intramedullary nailing for pediatric long bone fractures: experience with 175 fractures. Scand J Surg. 2011;100(3):208-15. DOI: https://doi.org/10.1177/145749691110000313

Antabak A, Luetic T, Ivo S, Karlo R, Cavar S, Bogovic M, et al. Treatment outcomes of both-bone diaphyseal paediatric forearm fractures. Injury. 2013;44(3):11-5. DOI: https://doi.org/10.1016/S0020-1383(13)70190-6

Blackman AJ, Wall LB, Keeler KA, Schoenecker PL, Luhmann SJ, O’Donnell JC, et al. Acute compartment syndrome after intramedullary nailing of isolated radius and ulna fractures in children. J Pediatr Orthop. 2014;34(1):50-4. DOI: https://doi.org/10.1097/BPO.0b013e31829527de

Parikh SN, Wells L, Mehlman CT, Scherl SA. Management of fractures in adolescents. Instr Course Lect. 2011;60:397-411.

Lu D, Lin Z, Zhang JD, Chen H, Sun LJ. Treatment of pediatric forearm midshaft fractures: Is there a difference between types of orthopedic surgeon? Orthop Traumatol Surg Res. 2017;103(1):119-22. DOI: https://doi.org/10.1016/j.otsr.2016.11.008

Yalçinkaya M, Doğan A, Ozkaya U, Sökücü S, Uzümcügil O, Kabukçuoğlu Y. Clinical results of intramedullary nailing following closed or mini open reduction in pediatric unstable diaphyseal forearm fractures. Acta Orthop Traumatol Turc. 2010;44(1):7-13. DOI: https://doi.org/10.3944/AOTT.2010.2260

Garg NK, Ballal MS, Malek IA, Webster RA, Bruce CE. Use of elastic stable intramedullary nailing for treating unstable forearm fractures in children. J Trauma. 2008;65(1):109-15. DOI: https://doi.org/10.1097/TA.0b013e3181623309

Kumar A, Ray A, Kaura N. Tens (Titanium elastic nail system): A good option for managing both bone forearm fracture. Nat J Clin Orthop. 2019;3(1):15-8. DOI: https://doi.org/10.33545/orthor.2019.v3.i1a.05

Jain S, Mohanachandran J, Mohan R. Outcomes and complications of Titanium elastic nailing for forearm bones fracture in children: our experience in a district general hospital in the United Kingdom. Acta Orthop Belg. 2023;89(3):539-46. DOI: https://doi.org/10.52628/89.3.12032

Slongo TF. Complications and failures of the ESIN technique. Injury. 2005;36(1):78-85. DOI: https://doi.org/10.1016/j.injury.2004.12.017