Abstract
Forearm fractures are common upper limb injuries among children and usually treated non-operatively. Failure of non-operative treatment, open injuries and multiple fractures are the indications for surgery in paediatric both bone forearm fractures. Intramedullary nailing is considered as minimally invasive procedure with excellent to fair outcomes but it is not free of complications. We reviewed the results and evaluated the outcomes of IM fixation of forearm fractures in children by Rush nails to understand the risks and complications associated with these procedures. A retrospective crossectional study of all paediatric patients treated for diaphyseal forearm fractures for period of five years in a tertiary care setup. Complications were classified according to modified Clavien-Dindo complication classification system. Outcomes were graded depending upon complication grade along with range of motion of forearm. A total of 25 patients were included in the study. Mean time for fracture union was 10.56 weeks. Outcomes were excellent in 16 (64%), good in 7 (28%), fair in 2 (8%) patients and no poor outcome was noted. Ten minor complications were seen. Fixation of paediatric forearm fractures by intramedullary Rush nail is minimally invasive procedure and outcomes are excellent to fair with acceptable complication rates.
Highlights
Forearm fractures are common upper limb injuries among children and usually treated non-operatively
Outcomes were excellent in 16 (64%), good in 7 (28%), fair in 2 (8%) patients and no poor outcome was noted
Results of nonoperative treatment of paediatric diaphyseal forearm fractures are favourable in the majority of cases, despite of that surgical treatment for such injuries are increasing nowadays
Summary
Forearm fractures are common upper limb injuries among children and usually treated non-operatively. We reviewed the results and evaluated the outcomes of IM fixation of forearm fractures in children by Rush nails to understand the risks and complications associated with these procedures. A study showed an increase in the rate of surgical treatment of paediatric forearm fractures in the form of intramedullary (IM) nailing from 1.8% to 22% over. Several studies have shown excellent to good results of IM nailing of paediatric forearm fractures, leading to increase in practice of IM fixation of such injuries.[3,4] There are several minor and major complications associated with IM Fixation including delayed union, nonunion, need to frequently expose the fracture site, compartment syndrome (CS), and wound problems.[4]
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