A prospective study of surgical management in fracture of both bone forearm shaft using titanium elastic nailing system in pediatric patients

Abstract

Introduction: Both bone forearm fractures are common orthopaedic injuries in pediatric population which present significant challenges to the orthopaedic community. It is not only important to treat them adequately but also to recognize the overall impact a fracture can have on a child, possibly limiting physical activity. Forearm fractures comprise 40% or more of pediatric fractures.Majority of these fractures can be treated conservatively with closed reduction and cast immobilization. A recognized failure rate has been reported up to 7% to 32%. Commonly two operative treatment modalities are employed at present: open compression plating and flexible intramedullary nailing. Each modality has advantage and disadvantage. Objective: Assess the functional outcome and complications associated with Titanium Elastic Nailing System in fracture of both bone forearm in pediatric patients.Materials and Methods: 20 Patients with both bone forearm shaft fracture aged between 6-16 years admitted to Chigateri General Hospital and Bapuji Hospital attached to J.J.M. Medical College Davanagere in the period from September 2019 to August 2021.Results: In our study, majority of the patients were boys, with an average age of 10.5 years with mid 1/3rd shaft transverse fractures being the most common, and self-fall while playing was the most common mode of injury. The surgery required minimum dissection, short operation time with hardly any risks of intraoperative complications. The average fracture union time was 9 weeks with patients recovering near normal functions of forearm at the earliest.We didn’t encounter any major post-operative complications in our study, and 95% of the patients had excellent range of motion at wrist, elbow and radio-ulnar joints and 5% had satisfactory range of motion.Conclusion: TENS nailing in both bone forearm shaft fractures in pediatric age group provides excellent results with advantages of early union, excellent recovery of function, minimal invasive and decreased time of surgery.