[Surgical management of unstable both-bone forearm fractures in children].
OBJECTIVE
We evaluated the results of two different surgical methods for the treatment of unstable both-bone forearm fractures in children.


METHODS
Thirty-five children with unstable both-bone forearm fractures were retrospectively evaluated. Of these, 14 patients (group 1; 4 girls, 10 boys; mean age 13 years; range 10 to 15 years) underwent open reduction and plate-screw fixation, and 21 patients (group 2; 5 girls, 16 boys; mean age 11.5 years; range 8 to 13 years) underwent closed reduction and intramedullary fixation. All the fractures in group 1 were closed, while, in group 2, there were 15 closed and six type 1 open fractures. The mean time to surgery was 4.3 days in group 1, and 3.1 days in group 2. The results were assessed using the criteria of Price et al. The mean follow-up was 34 months in group 1, and 37 months in group 2.


RESULTS
Nonunion was observed in only one patient in group 1. The mean time to union was 7.2 weeks (range 6 to 11 weeks) in group 1, and 6.5 weeks (range 6 to 10 weeks) in group 2. According to the criteria of Price et al., the results in group 1 were perfect in 11 patients (78.6%), good in two patients (14.3%), and fair in one patient (7.1%). In group 2, 18 patients (85.7%) had excellent, three patients (14.3%) had good results. Complications were major in three patients (21.4%) and minor in two patients (14.3%) in group 1, compared to one major (4.8%) and eight minor (38.1%) complications in group 2. None of the patients had limb-length discrepancy, joint deformity, angular or rotational deformity, or complications such as synostosis and infection.


CONCLUSIONS
It was concluded that intramedullary nailing was safe, effective, and easy to perform in the management of unstable both-bone forearm fractures in children.
Ozkaya
Ufuk
U
Taksim Eğitim ve Araştirma Hastanesi, Ortopedi ve Travmatoloji Kliniği, Istanbul. ufukozkaya2004@yahoo.com
Parmaksizoğlu
Atilla Sancar
AS
Kabukçuoğlu
Yavuz
Y
Yeniocak
Sedat
S
Sökücü
Sami
S
D000293:Adolescent; D001860:Bone Plates; D001863:Bone Screws; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology*; D005596:Fractures, Closed / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005597:Fractures, Open / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005599:Fractures, Ununited / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D008297:Male; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*