Evaluation of Both-Bone Forearm Fractures Fixation in Children by Elastic Stable Intramedullary Nailing

Document Type : Original Article

Authors

1 Department of Orthopedic Surgery, 30th June Hospital, Ministry of Health, Port Said, Egypt.

2 Department of Orthopedic Surgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt.

Abstract

Background: Both-bone forearm fractures are common pediatric injuries that were traditionally treated with above-elbow plaster casting. However, casting is associated with complications including prolonged immobilization, loss of reduction, and refracture. Elastic stable intramedullary nailing (ESIN) has emerged as an effective alternative for internal fixation of pediatric both-bone forearm fractures.
Aim of the work: This study aimed to evaluate the radiological and functional outcomes of ESIN fixation of both-bone forearm fractures in children.
Patients and methods: This prospective study included 22 children aged 6-14 years with both-bone forearm fractures treated with ESIN between October 2022 and June 2023. Relevant clinical data was collected and radiographs were obtained post-operatively and at final follow-up (minimum 6 months) to assess fracture alignment and healing. Price scoring was used to evaluate functional outcomes.
Results: All fractures healed uneventfully at a mean of 7.37 weeks. Based on Price et al. scoring, 19 patients (86.3%) had excellent and the remaining three patients (13.7%) had good functional outcomes. Complications included nail protrusion\pain in two patients (9.0%) and pin tract infections in one patient (4.5%).
Conclusion: ESIN provides effective and reliable fixation for both-bone forearm fractures in children, allowing early mobilization with low complication rates and excellent clinical and radiological outcomes. It is a superior alternative to casting for these injuries.

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