The results of intramedullary nailing in children who developed redisplacement during cast treatment of bothbone forearm fractures

Levent Celebi, Hasan H. Muratli, Ozgur Dogan, Mehmet F. Yagmurlu, Ertugrul Aksahin, Ali Bicimoglu,

Abstract

Objectives: We assessed the results of intramedullary nailing in children who developed redisplacement during cast treatment of both-bone forearm fractures.\r\nMethods: Twenty-eight children (19 boys, 9 girls; mean age 10.6 years; range 8 to 15 years) were treated with intramedullary fixation upon failure of initial reduction of both-bone forearm fractures after a mean of four weeks (range 3 to 6 weeks) of cast treatment. Intramedullary fixation was performed following closed (n=20) or open (n=8) reduction using K-wires in the first 10 cases, and titanium elastic nails in 18 cases. Single bone fixation was possible in four (14.3%) cases. For malunion assessment, the amount and location of the maximum radial bow were measured and compared with the normal side and with corresponding extremities of age-matched controls. Functional results were assessed using the Grace-Eversmann criteria. The mean follow-up was 14 months (range 12 to 18 months). \r\nResults: Except for a nonunion of the ulna in one patient who underwent single bone fixation, all correction losses could be restored to normal alignment and united within a mean of seven weeks (range 6 to 8 weeks). The amount and location of the maximum radial bow did not differ significantly from those of the normal side and control extremities (p>0.05). Functional results were excellent in 25 patients (89.3%), good in two patients (7.1%), and unacceptable in one patient (3.6%). None of the patients developed infection, neurapraxia, or after removal of the nail, angulation, refracture, or extremity length discrepancy.\r\nConclusion: Intramedullary fixation for correction losses during cast treatment of both-bone forearm fractures is a safe and inexpensive treatment, allowing early mobilization and providing excellent anatomic and functional results.

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