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. 2008 Jun;32(3):421-3.
doi: 10.1007/s00264-007-0334-9. Epub 2007 Mar 1.

Paediatric forearm fractures: the increasing use of elastic stable intra-medullary nails

D Cumming  1 , N Mfula, J W M Jones
Affiliations

Paediatric forearm fractures: the increasing use of elastic stable intra-medullary nails

D Cumming et al. Int Orthop. 2008 Jun.

Abstract
in English, French

This paper entails a clinical review of outcomes and complications of 19 consecutive paediatric patients having undergone elastic stable intramedullary nailing for diaphyseal forearm fractures over a one year period. The mean age of patients was 9 years. The majority were male with a ratio of 17:2. In this group there were two patients with grade 1 open fractures. Four of the fractures required open reduction due to difficulty in reduction and soft tissue interposition. All fractures went on to osseous union with minimal deformity and full recovery. There were three complications which included one EPL rupture requiring delayed repair, one EPB partial rupture repaired at time of surgery, and one superficial radial nerve injury. Two patients also presented with nails penetrating the skin prior to removal. Elastic stable intramedullary nails offer good fixation to control deformity in midshaft forearm fractures for paediatric patients. However there is a high rate of possible complications around the radial insertion point.

L’étude clinique des complications à propos d’une série consécutive de 19 patients nécessitant l’utilisation d’un enclouage élastique stable intra médullaire pour fracture de la diaphyse des os de l’avant-bras a été réalisée. Cette étude a été réalisée sur une période d’un an. L’âge moyen des patients était de 9 ans avec une majorité de garçons (17 garçons et 2 filles). Dans ce groupe, trois patients présentaient une fracture ouverte de grade I. 4 patients ont nécessité une réduction à ciel ouvert secondaire à une interposition tissulaire. Trois complications ont été constatées, deux ruptures tendineuses et une lésion superficielle du nerf radial. 2 patients présentaient également une lésion cutanée secondaire en regard des clous. L’enclouage intra médullaire élastique stable permet une excellente fixation de la déformation de la fracture des deux os de l’avant bras chez les enfants mais cependant, le taux de complications est relativement élevé au niveau du point d’insertion radial.

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Figures

Fig. 1
Fig. 1
Lateral radiograph of a mid-shaft forearm paediatric fracture
Fig. 2
Fig. 2
Radiograph showing standard method of fixation
Fig. 3
Fig. 3
Insertion of radial nail at 1st and 2nd extensor interval through open procedure with direct vision of structures
Fig. 4
Fig. 4
Insertion of ulna nail through open procedure
See this image and copyright information in PMC

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