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Observations on Intramedullary Nailing in Diaphyseal both Bone Forearm Fractures in Children

Mansoor Ahmad Tali, Shafeeq Ahmad Sofi

Abstract: Purpose: Observations on intramedullary nailing in diaphyseal both bone forearm fractures in children aged 8-14 years. Patients and Methods: 50 patients with an age group of 8-14 years ,with displaced unstable diaphyseal forearm fractures, including the segmental and open fractures (Gustilo & Anderson type 1 & 2) and fractures with loss of reduction in the first week of casting were included in the study. Intramedullary nailing of both bone forearm fractures was done under general anaesthesia using 2-2.5mm diameter flexible titanium nails. Patients were followed at two weeks, four weeks, six weeks, eight weeks and then at monthly intervals upto 9 months. Final follow up was done at 9 months and results were assessed clinically using Daruwalla criteria with restoration of forearm rotation. Results: Majority of patients (72%) were in the age group of 11-14 years with an average age of 11 years. Male children (76%) outnumbered the females (24%). Majority of the patients had involvement of left side (68 %) as compared to right side (32 % ). Mode of injury was sports related fall in 22 (44%) patients, fall from height in 14 (28%) patients, fall from bicycle in 7 (14%) patients & road traffic accident (RTA) in 7 (14%) patients. Summer was season with maximum number of patients (42%) followed by spring (26%), autumn (24%) & winter (8%). Middle third of the radius & ulna was most common site of fracture (52%), followed by distal third (38%) & least involved site was proximal third (10%) of forearm. 12% of the fractures were open type (Gustillo Type 1 and 2) while 88% were closed type. Fracture pattern was transverse in 34 (68%) and Oblique 16 (32%) cases. Average time from injury to intervention was 37 hours. In 38 (76%) cases, closed reduction and nailing was achieved using 2 to 2.5 mm flexible titanium nails while in 12 (24%) cases, open reduction through limited incisions was done. The average surgical time was 40 minutes. The average hospital stay was 2.3 days. The average union time was 8 weeks with a range of 6-12 weeks. In all patients, removal of implant was done at 6 months. At final follow up, excellent results were seen in 46 (92%) patients & good results in 04 (8%) patients using Daruwalla criteria with restoration of forearm rotation. Conclusion: In children aged 8-14 years, the displaced diaphyseal forearm fractures, including open fractures (Gustilo & Anderson type 1 & 2) and fractures with loss of reduction in the first week of casting can be treated by intramedullary nailing with good to excellent functional results.

Keywords: Diaphyseal forearm fractures, Intramedullary nailing, Children

Country: India, Subject Area: Medical Surgical

Pages: 1364 - 1368

Edition: Volume 8 Issue 7, July 2019

How to Cite this Article?

Mansoor Ahmad Tali, Shafeeq Ahmad Sofi, "Observations on Intramedullary Nailing in Diaphyseal both Bone Forearm Fractures in Children", International Journal of Science and Research (IJSR), https://www.ijsr.net/archive/v8i7/show_abstract.php?id=ART20199876, Volume 8 Issue 7, July 2019, 1364 - 1368

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