[Osteosynthesis in proximal forearm fractures in children].
OBJECTIVE
Closed reduction and fixation of displaced proximal radial neck or ulnar fractures with elastic stable intramedullary nailing (ESIN); prevention of circulatory disturbances and functional deficits following open reduction.


METHODS
Proximal radial neck fractures > 45 degrees displacement (< 10 years of age) or > 20 degrees (> 10 years of age); proximal extraarticular ulnar fractures > 10 degrees malalignment; combination injuries (Monteggia fracture, Monteggia-equivalent injury).


METHODS
Minimally displaced or undisplaced fractures.


METHODS
Radius: distal implantation of the nail; touching and fixation of the proximal fragment with the tip of the nail, if need be following digital or percutaneous partial reduction (Kirschner wire); definitive reduction by torsion of the nail. Ulna: distal implantation of a prebent nail; the prebent curve is placed opposite to the malalignment.


METHODS
Functional treatment, no additive immobilization, no physical therapy.


RESULTS
78-87% very good and good functional results.
Schmittenbecher
Peter P
PP
Kinderchirurgische Klinik, Klinikum Karlsruhe, Karlsruhe, Germany. peter.schmittenbecher@klinikum-karlsruhe.de
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005543:Forearm Injuries / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D008297:Male; D011885:Radius Fractures / Q000601:surgery*; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000601:surgery*