Publication: Intramedullary Nailing System in Unstable Both Bone Diaphyseal Fractures in Children
Date
2017
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Forearm fractures in pediatric population is usually managed conservatively. Unstable
fractures need operative intervention like closed or open intramedullary nailing or
open reduction and internal fixation with plates and screws. However, there is no
consensus regarding the method of treatment according to age group.
Objective
To standardize the use of elastic nailing system as effective form of treatment in
terms of function, cost and lower complications as compared to widely used titanium
nails in developed countries.
Method
Sixty eight pediatric patients with both bone forearm diaphyseal fractures were
managed with closed reduction and intramedullary fixation with rush nail or k-wire
and followed at least for 6 months for evaluation of radiological and functional
outcome.
Result
Patients were divided into two age groups, Group A for age of 5 to 9 years (26
patients) and Group B for age of 10-15 years (42 patients). The mean time for union
for Group A patient was 7.31 weeks which was significantly lower than that of Group
B patients of 9.33 weeks (p-value <0.05). All the patients in Group A had excellent
outcome and 36 (85.7%) patients had excellent outcome and 6 (14.3%) had good
outcome in Group B. 5 out of 68 cases (7.35 %) had minor complications (2 in Group
A and 3 in Group B). The mean time for implant removal was 17.9 weeks in Group A
and 22.9 in Group B.
Conclusion
Intramedullary fixation for unstable diaphyseal both bone fractures of forearm is safe
and cost effective method of treatment with good to excellent functional outcome
with union time being significantly lower in younger age group.
KEY WORDS
Children, diaphyseal forearm fracture, intramedullary nail
Description
KC BB,1 Lamichhane N,1 Parajuli SP,1 Maharjan S2
1Department of Orthopedics
Western Regional Hospital, Pokhara, Nepal.
2Department of Radiodiagnosis
Grande International Hospital,
Kathmandu, Nepal.
Keywords
Children, diaphyseal forearm fracture, intramedullary nail