A prospective study of management of closed diaphyseal fractures of radius and/or ulna in children with intramedullary titanium elastic nail system

Abstract

Background & Aim: Intra-medullary elastic nailing system is an ideal device for the treatment of pediatric forearm fractures. It is simple, safe, minimally invasive technique and has a fewer complications. The aim of the study was to evaluate and report our experiences regarding union rates, clinical and functional outcome and complications associated with this treatment modality in BBF between age group of 5 to 15 years. Material & Methods: 40 cases of pediatric diaphyseal both bone forearm in children of age group 5 to 15 years operated at National Institute of Medical Science and hospital, Jaipur meeting the inclusion and the exclusion criteria ( as given below) managed between January 2015 to December 2015 with TENS were prospectively reviewed. The final functional and clinical outcome & complications were assessed at 6 month of follow up by Andersons et al criteria. Results: Of all 40 patients had undergone close reduction in which 2 required open reductions. All fractures united at a mean of 7.95 weeks (range 6-10 weeks) with achievement of full R.O.M at elbow and wrist in majority with reported restriction in 3 cases. There were no major complications but encountered minor complications in 18 patients such as pain (22.5%), hardware skin irritation (12.5%), and pin track infection (10%). The final functional outcome evaluated by Andersons et al criteria showed 90% excellent results and remaining showed good outcome. Conclusion: TENS is an ideal device for the treatment of pediatric forearm fractures as it is a simple, safe, minimally invasive technique and has fewer complications. It also does not interfere with growth of the forearm and provides early union due to non interference of fracture hematoma and minimal periosteal stripping. It provides shorter hospital stay, rapid return to daily activity & school, avoids long & uncomfortable immobilization & cosmetically acceptable