Assessment of Radiographic and Functional Outcomes of Flexible Intramedullary (IM) Nailing in Adolescent Patients with Forearm Fractures: A Clinical Study

Abstract

Introduction: There are various methods of management of fractures in both bones of forearm in children. Historically, closed reduction and plaster cast application has been the gold standard in management of these fractures, however there are increased chances of re-displacement, particularly in older children. Aim of the study was to assess clinical outcomes of flexible intramedullary nailing in adolescent patients with forearm fractures. Material and methods: The study was performed in the Department of Orthopedics of the Medical institute. A total of 18 patients with age ranging between 10-16 years of age with a both-bone forearm fracture that was planned to treat with IM nailing were selected for the study. The subjects were evaluated of their preoperative and follow-up anteroposterior (AP) and lateral radiographic views of forearm Radiographic measurements were obtained using a pencil and goniometer and it included angulation of the fracture site, percentage translation of the distal fragment, and location of the ulnar fracture in relation to the radius. Results: There were 18 patients included in the study. The mean age of the patients was 12.34 years. The number of male patients was 11 and number of female patients was 7. We observed that the union of fractured bones at 3 months was seen in 50% patients; whereas, bony union at 6 months was seen in 72.3% patients. Loss of forearm rotation was seen in 22.22% patients. The complications seen were in 3 and 2 patients, that were both major and minor respectively. Conclusion: We conclude that Intramedullary nailing of forearm fractures in adolescent patients is an equally very efficacious treatment as compared to plate and screw fixation.