Refractures of the paediatric forearm with the intramedullary nail in situ.
Forearm fractures in children are common. When conservative treatment fails, internal fixation with Elastic Stable Intramedullary Nailing (ESIN) become the first choice in the operative treatment of diaphyseal forearm shaft fractures. Refractures with the intramedullary nail in situ are known to occur but formal guidelines to guide management in such fractures are lacking. We present a well-documented case of a radius midshaft refracture in a 12-year-old boy with the intramedullary nail in situ, managed by closed reduction. Literature is reviewed for this type of complication, the treatment of 30 similar cases is discussed and a treatment strategy is defined. The refracture of the paediatric forearm fracture with the intramedullary nail in situ is a rare, but probably under recognised complication which is observed in approximately 2.3% of the study population. Closed reduction may be considered in these cases.
Department of Orthopaedic Surgery, VU Medical Centre, Amsterdam, The Netherlands.
Pim W
PW
van Egmond
Hans A
HA
van der Sluijs
Barend J
BJ
van Royen
Rachid
R
Saouti
D001858:Bone Nails; D002648:Child; D005500:Follow-Up Studies; D005543:Forearm Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006801:Humans; D008297:Male; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D012008:Recurrence