Management of pediatric both-bone forearm fractures by titanium elastic nailing system: A prospective study of 40 cases

Abstract

Context: Diaphyseal fractures of the radius and ulna are common in the pediatric population. The standard management for pediatric forearm fractures remains conservative management with closed reduction and immobilization with above-elbow plaster cast. Although the fracture unites readily, malunion is very common. Stiffness of joints and compartment syndrome are other complications of conservative management with plaster cast. The introduction of titanium elastic nailing system (TENS) has changed the treatment scenario of fracture of both-bone forearm. Aims: The aim of this study is to evaluate the functional and cosmetic outcome of the management of fracture both-bone forearm by closed reduction and internal fixation with titanium elastic nail system. Subjects and Methods: A total of 40 patients aged 5–15 years with fracture of both radius and ulna were managed by internal fixation with titanium elastic nail. Closed reduction under image intensifier control was achieved in most of the patients. Prospective follow-up was done for 6 months. Results: Results were analyzed in reference to union, symptoms, and range of motion of adjacent joints using Price et al. criteria for outcome evaluation. In our study, 87.5% of patients showed excellent, 10% showed good, and 2.5% showed fair outcome. Conclusion: Better functional and cosmetic outcome with minimal complications is achieved with internal fixation with titanium elastic nail system. TENS may be considered as an alternative to conservative treatment.