Treatment outcomes of both-bone diaphyseal paediatric forearm fractures.
BACKGROUND
Elastic-stable intramedullary nailing (ESIN), is an accepted method for stabilization of unstable forearm shaft fractures in children. This study analyzed the radiographic and functional outcomes of intramedullary nailing of forearm diaphyseal fractures in children.


METHODS
A retrospective analysis was performed of children with forearm shaft fractures and open epiphyseal plates, treated with ESIN between 2000 and 2012 in our institution. Evaluation of cases was conducted minimum 14 months after osteosynthesis. Clinical results were evaluated according to the criteria developed by Price et al. and Flynn et al.


RESULTS
The study included 88 (42 boys) children. The average age of children at day injury was 10.5 ± 2.59 years (range 4-16), and at the review clinic was 13.4 ± 1.85 years (range 7-18). Forty six (52.3 %) had right forearm and 42 (47.7%) had left fracture respectively. Open reduction was required in 20 (22.7%) children. Primarily surgically were treated 62 (70.5%) children and 26 (29.5%) were operated as a second procedure after failed conservative management. There was one delayed union. Rotational forearm restriction with values between 11 and 20 degrees was present in nine children. Six children developed radial nerve hypoesthesia which eventually resolved with time. After removal of the implant one child sustained a re-fracture. The overall complication rate was 25%. Complete recovery to the original condition was noted in 76 (86.4%) children, eleven children (12.5%) had good and only one (1.1%) had poor outcome.


CONCLUSIONS
Our study suggests that ESIN osteosynthesis for diaphyseal forearm fractures remains a valid technique with very good functional results.
Division of Surgery, Department of Paediatric Surgery, University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia. Electronic address: aantabak@kbc-zagreb.hr.
Anko
A
Antabak
Tomislav
T
Luetic
Sjekavica
S
Ivo
Robert
R
Karlo
Stanko
S
Cavar
Marko
M
Bogovic
Suzana Srsen
SS
Medacic
D000293:Adolescent; D001858:Bone Nails; D002648:Child; D002675:Child, Preschool; D018483:Diaphyses / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005543:Forearm Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000601:surgery; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome
Children; Forearm fractures; Intramedullary nailing; Operative treatment; Outcome