TREATMENT OF UNSTABLE FOREARM FRACTURES WITH ELASTIC INTRAMEDULLARY OSTEOSYNTHESIS IN CHILDREN

Abstract

Introduction: Over the past years there has been a marked increase in the use of intramedullary fixation in the management of displaced forearm fractures in children. This reflects high incidents of redisplacement, malunion and functional limitations. Aim: This retrospective study was performed to analyze the functional results of the elastic intramedullary titanium nail fixation used in the treatment of unstable, diaphyseal forearm fractures in children. Material and methods: From March 2013 to March 2012, 235 patients with forearm fractures were treated at our institution. Percutaneous intramedullary f ixation with titanium nail was performed in 132 patients, 96 with unstable reposition and 36 with redislocation 48 hours after the injury. The mean age of the patients was 9.6 (5-13) years. In 34 patients (31%) limited open approach to one or both was necessary for reduction. Result: In 12 patients we encountered minor complications. The average union time was 7.5 (5-13) weeks. We rated the functional results using the Price grading scheme. Thirty-two patients obtained excellent results, four very good, four good and two scored poorly. Conclusion: Despite the minor complications, percutaneous intramedullary fixation with titanium nails is an appropriate and safe treatment method for unstable fractures of the forearm in children which cannot be treated by closed manipulation.