Close enders nailing as internal bracing for acute humeral diaphyseal fractures in children and adolescents

Abstract

Background: In children diaphyseal fractures of humerus are most commonly treated by close reduction and cast immobilisation. Surgical treatment is preferred only in the cases recalcitrant to conservative treatment (1). Aim of the study: The present prospective study is to analyse the functional outcome of close enders nailing in the management of diaphyseal fracture of humerus in children and adolescents Material and Methods: Thirty patients with diaphyseal fracture of humerus in children and adolescents were treated with close enders nailing. In our series, mean age of the patients was 13.05 years (10 to 16 year).Boys dominated our series (n=20 i.e.66.66%) and right side (n=22 i.e.73.33%) was more commonly involved in both sexes. All the fractures were stabilised with close reduction and internal fixation with antegrade Enders nailing. Result: Minimal follow up was six month. Timely union was observed in all except three in an average of 10.81 weeks. In two cases union was delayed (14 and 16 weeks). One case faced nonunion and was treated with open reduction and internal fixation with dynamic compression plate with bone grafting.Observation: Functional outcome was evaluated using DASH Score. We had 27 excellent, 02 good and 01 poor result in our series. Conclusion: Close enders nailing is very demanding, safe and efficient method of treatment of acute humeral diaphyseal fracture in children and adolescents, offers a biological method of fracture healing and can be considered as internal bracing(2). Level of evidence – IV (case series).