title: Outcome of elastic nailing of diaphyseal forearm fractures in adolescents after failure of conservative management.
abstract: OBJECTIVE
  This is a prospective study to evaluate the efficacy of elastic nails for the treatment of diaphyseal forearm fractures after failure of conservative management.
  
  
  METHODS
  In 35 patients with a mean age of 15.3 years (14-17 years), elastic nails were used for the treatment of diaphyseal forearm fractures after failure of conservative management. In 32 patients (91.4%), we performed closed reduction. In the remaining 3 (8.6%), closed reduction failed and an open reduction, through a minimal approach, was required before nailing.
  
  
  RESULTS
  After a mean follow-up of 31 months (range 24-48 months), 20 (60%) patients had an excellent result 10 (34.3%) patients had a good result, and two (5.7%) patients had fair result. The mean time of union was 12 weeks (range 8-15). The mean time in cast was 8.5 weeks (range 7-11). Full range of elbow movement was regained in all cases; however, supination and pronation were limited in two patients. One patient had a superficial infection at the site of entry of the ulnar nail which was successfully treated with oral antibiotics and daily dressing. Neurapraxia affecting superficial branch of the radial nerve in one patient was resolved over a period of time. One case with partial rupture of extensor pollicus longus tendon was reported. There was one case of delayed union. No cases of refracture were reported after removal of the implant.
  
  
  CONCLUSIONS
  In adolescents, intramedullary fixation by using elastic nail plus cast immobilization provides effective treatment for diaphyseal forearm fracture when closed management has failed. However, it is of special importance to follow the right indication and to pay attention to correct technical procedure.
authors: Orthopaedic Department, Mansoura Faculty of Medicine, Mansoura University Hospital, Mansoura 35516, Egypt. aymanhusen2002@yahoo.com
authors: Ayman M
authors: AM
authors: Ali
mesh_terms: D000293:Adolescent; D001858:Bone Nails; D018483:Diaphyses / Q000293:injuries / Q000601:surgery; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011885:Radius Fractures / Q000601:surgery*; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000601:surgery*