Functional Outcomes of Pediatric Both Bone Fractures Fixed with Titanium Elastic Nails: : A Hospital Based Study

Abstract

Background: Successful treatment of both bone fractures depends on the restoration of normal alignment and full recovery of range of motion that can be achieved by either closed reduction and casting or surgical intervention. Number of surgical treatment modalities have been mentioned for unstable pediatric both bone fractures that includes Kirschner wire fixation, plating, external fixation and elastic intramedullary nailing
 Methods: This was descriptive cross-sectional study performed from January 2016 to December 2019. A total of 85 diaphyseal pediatric forearm fractures were treated surgically with TENs during this period. Functional outcomes and complications were analysed 6 months after surgery.
 Results: The mean age of patients in our study was 10.67±1.88. There were 50 (64.1%) male and 28 (35.9%) female. Incidence of fracture is higher in left side 47 (60.2%) in comparison to right side 31 (39.8%). Thirteen (16.7%) fractures were in proximal third, 50 (64.1%) in middle third and 15 (19.2%) in distal third of both bone forearm.There were excellent outcomes in 91%, good outcomes in 6.4% and fair results in only 2.6% of patients.Seven different types of complications were noted including skin irritation 8 (10.2%), cortex perforation in 2 (2.5%) and iatrogenic fracture in 1 (1.3%) case.
 Conclusions: Titanium elastic nailing is excellent treatment option for displaced unstable pediatric both bone fractures especially in elderly children. This is technically easy, minimally invasive procedure where bone healing is relatively fast, implant removal is easy with excellent cosmesis of skin without long ugly scar in forearm.

Evaluation of the Functional Outcome of Both Bone Forearm Fractures in the Pediatric Population With the Titanium Elastic Nailing System in a Tertiary Care Center

“…The improvement in range of motion was significant over time in patients who underwent intramedullary nailing. The overall complication rate in our study was 6%, which is similar to the rates described by Kc et al [ 21 ]. According to criteria by Price et al, 90% showed excellent outcomes, 7% showed good outcomes, and 3% showed fair outcomes [ 23 ].…”

“…The results of our study are consistent with the clinical and radiological results of previous studies of Open Reduction and Internal Fixation (ORIF) of fracture of both the radius and ulna [ 8 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ]. Participants in our study had a mean age of 8.8 years, ranging between 0 and 15 years, with 53% of patients aged between six and 10 years.…”

“…In our study, the incidence of fracture was almost similar between the left and right sides. However, Kc et al, in a study done in 2013, reported that the incidence of fracture is higher on the left side because the left side is usually nondominant and used as a protective function while the patients fall on the ground [ 21 ].…”

Single Bone Fixation of The Radius Versus Ulna in Diaphyseal Forearm Fractures in Children

“…The restoration of supination and pronation is the primary determinant of successful outcomes. The majority of earlier investigations on pediatric forearm fractures revealed favorable results during follow-up [7,8].…”