title: Comparison of hybrid fixation versus dual intramedullary nailing fixation for forearm fractures in older children: Case-control study.
abstract: OBJECTIVE
  The aim of the present study was to compare the clinical outcomes of hybrid fixation using elastic stable intramedullary nailing (ESIN) for the radius and plate screw fixation for the ulna (Hybrid group) with dual ESIN fixation (D-ESIN group) for both-bone forearm fractures in children between 10 and 16 years of age.
  
  
  METHODS
  Fifty patients with both-bone forearm fractures (28 patients in the Hybrid group and 22 patients in the D-ESIN group) were reviewed. Functional outcomes were evaluated according to the criteria of Price et al. Radiological results were assessed by fracture union at three and six months and bone union time. Postoperative complications were also recorded.
  
  
  RESULTS
  The times of fluoroscopy intraoperatively and duration of immobilization postoperatively were significantly lower in the Hybrid group (P < 0.05). The union rate of the ulna at three months postoperatively in the hybrid group was significantly higher than that in the D-ESIN group (P < 0.05). The average time of bone union was significantly shorter in the hybrid group than that in the D-ESIN group (P < 0.05). There were no differences according to the satisfactory rate and degree, the major and minor complications between the groups.
  
  
  CONCLUSIONS
  Hybrid fixation is superior in terms of the times of fluoroscopy intraoperatively, duration of immobilization postoperatively, delayed union rate of the ulna and the average time of bone union. Therefore, hybrid fixation is an alternative treatment for both-bone forearm fractures in children between 10 and 16 years of age.
authors.affiliation: Department of Orthopaedics Surgery, The Second Affiliated Hospital of Wenzhou Medical University, NO. 109, XueYuan West Road, Wenzhou 325000, Zhejiang Province, China.
authors.forename: Yongzeng
authors.initials: Y
authors.lastname: Feng
authors.affiliation: Department of Orthopaedics Surgery, The Second Affiliated Hospital of Wenzhou Medical University, NO. 109, XueYuan West Road, Wenzhou 325000, Zhejiang Province, China.
authors.forename: Xiaolong
authors.initials: X
authors.lastname: Shui
authors.affiliation: Department of Orthopaedics Surgery, The Second Affiliated Hospital of Wenzhou Medical University, NO. 109, XueYuan West Road, Wenzhou 325000, Zhejiang Province, China.
authors.forename: Jianshun
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Orthopaedics Surgery, The Second Affiliated Hospital of Wenzhou Medical University, NO. 109, XueYuan West Road, Wenzhou 325000, Zhejiang Province, China.
authors.forename: Leyi
authors.initials: L
authors.lastname: Cai
authors.affiliation: Department of Orthopaedic Trauma, Nanfang Hospital, Southern Medical University, NO. 1838, Guangzhou Road, Guangzhou 510000, Guandong Province, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Orthopaedics Surgery, The Second Affiliated Hospital of Wenzhou Medical University, NO. 109, XueYuan West Road, Wenzhou 325000, Zhejiang Province, China. Electronic address: hongjianjun_fey@163.com.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Hong
mesh_terms: D000293:Adolescent; D001858:Bone Nails; D001860:Bone Plates; D001863:Bone Screws; D016022:Case-Control Studies; D002648:Child; D005260:Female; D005543:Forearm Injuries / Q000000981:diagnostic imaging / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods*; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000379:methods; D017102:Fracture Healing; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D011184:Postoperative Period; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013701:Temporal Bone; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Both-bone forearm fractures; Children; Elastic stable intramedullary nailing; Hybrid fixation; Open reduction and internal fixation