Treatment of Paediadric Forearm Fractures with Titanium Elastic Nails

Abstract

Background: A prospective analysis of a case series of diaphyseal forearm fractures in children treated with titanium elastic nails is presented. Methods: Between 2012 and 2014, 45 children aged 5-15 years with displaced diaphyseal forearm fractures underwent titanium elastic nailing. Both bones were fractured in 32 patients, ten fractured only the radius, and three experienced ulna fracture. Eighteen children had unstable irreducible fractures, twenty had loss of reduction, and seven had open fractures. Titanium elastic nails were used to stabilize the fractures. All fractures were immobilized postoperatively with an above-elbow plaster slab for 2 weeks till the swelling is completely resolved followed by encouraging range of motion exercises. Results: Closed reduction and TENS was successful in 33 cases, including 25 double-bone fractures and eight single-bone fractures. Open reduction was unavoidable in seven fractures of both bones, and in five single-bone open fractures. Bone union was achieved in all patients at an average of 7 weeks. Conclusion:Titanium elastic nails fixation of pediatric forearm fractures revealed several advantages, a small incision for insertion, a low rate of complications, unhindered bone healing, and good clinical and radiological results. Key words: Diaphyseal; Radius and ulna; Pediatric; Forearm fractures; Fracture fixation; TENS