Clinical application of flexible titanium intramedullary nailing for the treatment of upper supracondylarfractures or the distal humeral metaphyseal-diaphyseal junction fractures in children

Abstract

Objective To discuss the advantages and disadvantages of using flexible titanium intramedullary nailing for the treatment of upper supracondylar fractures or the distal humeral metaphyseal-diaphyseal junction fractures in children.Methods Between 2009 and 2011,5 supracondylar humeral fractures and 5 metaphyseal-diaphyseal junction fractures of the distal humerus underwent this procedure at our institution.In 4 patients,the fracture line was oblique,and in 6 patients,the fracture line was transverse.Results All these patients were followed up at 1、3、6、12 months (ranged from 2 to 21 months).All of the cases have healed well Baumann's angle (average 71.1°,64°～78°) 、and the lateral humeral- capitellar angle(average 37.5°,35°～40°) were all within normal range at the latest follow-up.All patients achieved free range of movement of the affected elbow.No visible malpositions,pseudo- arthrosis or nerve lesions were observed.Conclusions Using flexible titanium intramedullary nailing technique may get optimal outcomes for children with upper supracondylar humeral fractures or the distal humeral metaphyseal-diaphyseal junction fractures.These should be differentiated from the more common supracondvlar humerus fracture. Key words: Humeral fractures; Elastic stable intramedullary nailing; Elbow joint; Child