title: Elastic intramedullary nailing of paediatric fractures of the forearm: a decade of experience in a teaching hospital in the United Kingdom.
abstract: We present the results of 90 consecutive children with displaced fractures of the forearm treated by elastic stable intramedullary nailing with a mean follow-up of 6.6 months (2.0 to 17.6). Eight (9%) had open fractures and 77 (86%) had sustained a fracture of both bones. The operations were performed by orthopaedic trainees in 78 patients (86%). All fractures healed at a mean of 2.9 months (1.1 to 8.7). There was one case of delayed union of an ulnar fracture. An excellent or good functional outcome was achieved in 76 patients (84%). There was no statistical difference detected when the grade of operating surgeon, age of the patient and the diaphyseal level of the fracture were correlated with the outcome. A limited open reduction was required in 40 fractures (44%). Complications included seven cases of problematic wounds, two transient palsies of the superficial radial nerve and one case each of malunion and a post-operative compartment syndrome. At final follow-up, all children were pain-free and without limitation of sport and play activities. Our findings indicate that the functional outcome following paediatric fractures of the forearm treated by elastic stable intramedullary nailing is good, without the need for anatomical restoration of the radial bow.
authors.affiliation: Department of Trauma and Orthopaedics, Barts and The London NHS Trust, Royal London Hospital, Whitechapel Road, London E1 1BB, UK.
authors.forename: S-N
authors.initials: SN
authors.lastname: Kang
authors.forename: J
authors.initials: J
authors.lastname: Mangwani
authors.forename: M
authors.initials: M
authors.lastname: Ramachandran
authors.forename: J M H
authors.initials: JM
authors.lastname: Paterson
authors.forename: M
authors.initials: M
authors.lastname: Barry
mesh_terms: D000293:Adolescent; D001858:Bone Nails; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D004548:Elasticity; D004551:Elbow Joint / Q000503:physiopathology; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000379:methods*; D017102:Fracture Healing; D005597:Fractures, Open / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006784:Hospitals, Teaching; D006801:Humans; D011446:Prospective Studies; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*