scholarly journals Pediatric forearm fractures with tens: freedom of movements

2016 ◽  
Vol 2 (3) ◽  
pp. 142
Author(s):  
Shivanna Shivanna ◽  
Maruthi C. V.
Keyword(s):  
Range Of Motion ◽  
Bone Fractures ◽  
Case Series ◽  
Open Fractures ◽  
Forearm Fractures ◽  
Titanium Elastic Nailing ◽  
Fractures In Children ◽  
Elastic Nails ◽  
Both Bones ◽  
Single Bone

<p class="abstract"><strong>Background:</strong> A prospective analysis of a case series of diaphyseal forearm fractures in children treated with titanium elastic nails is presented.  </p><p class="abstract"><strong>Methods:</strong> Between 2012 and 2014, 30 children aged 5-15 years with displaced diaphyseal forearm fractures underwent titanium elastic nailing. Both bones were fractured in 25 patients, four fractured only the radius, and one experienced ulna fracture. Eleven candidates had unstable irreducible fractures, 13 had loss of reduction, and six had open fractures. Titanium elastic nails were used to stabilize the fractures. All fractures were immobilized postoperatively with an above-elbow plaster slab for 2 weeks till the swelling is completely resolved followed by encouraging range of motion exercises.<strong></strong></p><p class="abstract"><strong>Results:</strong> Closed reduction and TENS was successful in 20 cases, including 15 double-bone fractures and five single-bone fractures. Open reduction was completed in four fractures of both bones, and in six single-bone open fractures. Bone union was achieved in all patients at an average of 7 weeks. The ROM of the forearms was evaluated using the Daruwalla grading criteria. Excellent results were reported in 96% without significant complications after a mean follow-up of 20 months.</p><p class="Default"><strong>Conclusions:</strong> Titanium elastic nails fixation of pediatric forearm fractures revealed several advantages, a small incision for insertion, a low rate of complications, unhindered bone healing, and good clinical and radiological results thus achieving maximum range of motion at the earliest.</p>

scholarly journals Functional outcome of diaphyseal fractures of forearm in adolescents treated with TENS

2019 ◽  
Vol 5 (3) ◽  
pp. 69
Author(s):  
Divyanshu Goyal ◽  
S. L. Sharma ◽  
Laxmikant Meena ◽  
Ravindra Lamoria ◽  
Mahesh Bansal
Keyword(s):  
Range Of Motion ◽  
Functional Outcome ◽  
Case Series ◽  
Age Group ◽  
Forearm Fractures ◽  
Retrospective Case ◽  
Superficial Infection ◽  
Fractures In Children ◽  
Case Series Study ◽  
Diaphyseal Fractures

<p class="abstract"><strong>Background:</strong> A retrospective case series study was done on forearm diaphyseal fracture in adolescents treated with TENS (titanium elastic nailing system). Purpose of the study was analysis of functional outcome of TENS in forearm diaphyseal fractures in children between 12-18 year age group.</p><p class="abstract"><strong>Methods:</strong> We retrospectively evaluated 30 patients operated by same senior surgeon during the period from March 2014 to February 2015 with closed diaphyseal forearm fractures in age group 12–18 years treated with TENS in whom closed reduction could not be achieved. Nail diameter taken as 33-40% of narrowest diameter of diaphysys were introduced proximally in ulna and distally in radius under image intensifier in closed manner. Postoperatively, patients encouraged for active shoulder, elbow and finger movements and suture removal done after 2 weeks. Patients were followed up for minimum period of one year.  </p><p class="abstract"><strong>Results:</strong> In terms of union and range of motion using Anderson et al criteria 24 patients had excellent results, 4 patients had satisfactory results and one patient had poor result having non-union of ulna. Two patients had superficial infection at the nail entry site which eventually resolved. One patient lost for follow up.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that TENS in both bone forearm fractures in adolescent age group in terms of union and range of motion is a minimally invasive and effective method of fixation.</p>

Titanium Elastic Nails for Distal Radius-ulna Fractures in Young Dogs

2021 ◽  
Author(s):  
Harmanpreet Singh Sodhi ◽  
Ashwani Kumar ◽  
Arun Anand ◽  
Vandana Sangwan ◽  
Dhiraj Kumar Gupta
Keyword(s):  
Distal Radius ◽  
Bone Fractures ◽  
Weight Bearing ◽  
Medullary Canal ◽  
Long Term Results ◽  
Long Bone ◽  
Uneventful Recovery ◽  
Fractures In Children ◽  
Ulna Fractures ◽  
Elastic Nails

Background: Radius-ulna is the most frequently fractured bone of the pectoral limb in dogs with high predisposition to distal fractures. The smaller size of the distal fragment and open physis restrict the use of rigid fracture fixation techniques in distal fractures of growing dogs. Titanium elastic nails (TENs) are recommended in medical practice to stabilize long bone fractures in children. There is paucity of literature on TENs for the repair of radius-ulna fractures in dogs. Methods: This clinical study enrolled 10 dogs (7 grey hound and one each of Crossbred, Pomerenarian and Siberian Husky) suffering from distal radius-ulna (6 transverse and 4 short oblique) fractures since a mean ± SD duration of 3.40±4.5 days. The mean ± SD age and body weight of the dogs was 12.60±6.45 months and 14.09±6.41 Kg, respectively. All except one fracture was stabilized with two TENs inserted into the medullary canal of radial bone in a normograde manner from distal to proximal end using open cranio-lateral surgical approach. Result: Majority fractures achieved satisfactory reduction (n=8), radiographically. Weight bearing scores on walking increased gradually from day 12 (1.62 ± 1.51) to 45th (2.57±1.51), day 60th (3.75±0.5) and day 90 (4.0±0). Five dogs had uneventful recovery whereas remaining had major (n=2) or minor (n=3) complications. The length of the operated bone was non-significantly lesser as compared to contralateral healthy bone on day 60. Goniometric assessment of carpal joint of operated limb showed restricted range of motion on day 12 that improved to the near normal as contralateral healthy limb on day 60. Long-term results showed full (9) and acceptable (1) functional outcome. In conclusions, the TENs technique is simple and less invasive alternative fixation technique for distal radius-ulna fractures in young and light weighing dogs. As per authors, this is the first report on the use of TENs for the management of radius-ulna fracture in dogs.

scholarly journals Ulnar Nerve Injuries Post Closed Forearm Fractures in Paediatric Population: A Review of the Literature

2019 ◽  
Vol 13 ◽  
pp. 117955651984187
Author(s):  
Ioannis M Stavrakakis ◽  
Ioannis I Daskalakis ◽  
George E Magarakis ◽  
Zacharias Christoforakis ◽  
Maria S Katsafarou
Keyword(s):  
Ulnar Nerve ◽  
Case Reports ◽  
Case Series ◽  
Paediatric Population ◽  
Forearm Fractures ◽  
Review Of The Literature ◽  
Nerve Injuries ◽  
Fractures In Children ◽  
Ulnar Nerve Injury ◽  
Relative Case

Ulnar nerve injury as a result of closed forearm fractures in children is a rare but disastrous complication, affecting significantly the function of the upper extremity. The management of these injuries is still controversial in the literature. This is a review of small case series and case reports, in which an algorithm of treatment is proposed. A brief description of a relative case, which was treated successfully in our department, is presented as well. This case motivated the authors to perform this study.

scholarly journals Intramedullary Nailing of Both Bone Forearm Fractures in Children by Rush Nails and Titanium Elastic Nails

2018 ◽  
Vol 4 (1) ◽  
pp. 10-15
Author(s):  
Rajeev Dwivedi ◽  
Ruban Joshi ◽  
Subin Byanjankar ◽  
Sagar Panthi ◽  
Rahul Shrestha ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Forearm Fracture ◽  
Complication Rates ◽  
Forearm Fractures ◽  
Multiple Fractures ◽  
Fractures In Children ◽  
Group Outcomes ◽  
Limb Injuries ◽  
Significant Difference ◽  
Elastic Nails

INTRODUCTION: Forearm fractures are common upper limb injuries among children and usually treated nonoperatively. Failure of nonoperative treatment, open injuries and multiple fractures are the indications for surgery in paediatric both bone forearm fractures.  Intramedullary (IM) nailing is considered as minimally invasive procedure with excellent to fair outcomes but it is not free of complications. We reviewed the results and compared the outcomes of IM fixation by Rush nails with titanium elastic nails (TENs), to understand the risks and complications associated with this procedures. MATERIAL AND METHODS: We performed a retrospective review of all paediatric patients treated for diaphyseal forearm fractures from January 2011  to  December  2015.  Complications  were  classified  according  to  modified  Clavien-Dindo  complication classification system. Outcomes were graded depending upon complication grade along with range of motion of forearm. RESULTS: There was no statistically significant difference for mean time to fracture union between the Rush nailing (10.56 weeks ) group and TENs nailing group (9.85weeks) (P = 0.43). There was no statistically significant difference in outcomes between Rush nailing and TENs nailing group p=0.65. In Rush nailing group outcomes were excellent in 16 (64%), good in 7(28%), fair in 2( 8%) patients and no poor outcome were noted. In TENs nailing group outcomes were excellent in 11 (55%) , good in 6 (30%), fair in 3 (15%) patients and no poor outcomes were noted.  CONCLUSION: Fixation of pediatric forearm fractures by intramedullary Rush nails and titanium elastic nails (TENs) are minimally invasive procedures and results are excellent to fair with acceptable complication rates. Since Rush nails are easily available and affordable in developing countries like ours we can prefer Rush nails for intramedullary fixation of paediatric forearm fracture when indicated.   Journal of Universal College of Medical Sciences (2016) Vol.04 No.01 Issue 13, Page: 10-15

scholarly journals Management of Pediatric both-bone Forearm Fractures by Titanium Elastic Nailing System: A Prospective Study of 60 Cases

2021 ◽  
pp. 1-7
Author(s):  
Masood Ahmed Qureshi ◽  
Nuresh Kumar Valecha ◽  
Niaz Hussain Keerio ◽  
Syed Sajid Hussain ◽  
Hassan Amir us Saqlain ◽  
...  
Keyword(s):  
Bone Fractures ◽  
Forearm Fracture ◽  
Operating Time ◽  
Rigid Fixation ◽  
Forearm Fractures ◽  
Male Population ◽  
Effective Technique ◽  
Titanium Elastic Nail ◽  
Titanium Elastic Nailing ◽  
Elastic Nail

Intramedullary nailing procedure is highly appreciated by many phsyicians for treating pediatrics forearm fractures. Minimum operating time, fewer chances of incisions, faster bone healing, and accuracy in bone alignment less rigid fixation made this technique more popular and preferable. This study was specially designed to observed the management of pediatric both forearm fracture by using the titanium elastic nail technique. Methodology: Our prospective descriptive study was conducted in King Abdul Aziz Hospital Makkah Saudi Arabia from march 2018 to march 2021. Total 60 patients were enrolled which were treated with titanium elastic nail system (TENS). In this study patients with close displaced and open type 1 fractures with age range of 4 to 14 years were included. Results: Total 42.5% of participants were under the age of 10, and  57.5% of patients were above 10 years or equal to 10 years age. We reported 58.9% prevelance of injury among male patients. Along with these, we reported 53.4% cases with left side fractures and 60.3% had middle bone fractures. In our study, we reported that the overall average union time  was 9.10±1.8. Conclusion: Titanium elastic nailing is the most effective technique for managing unstable fractures among pediatrics. The male population was more prone to forearm fracture, especially at the middle third shaft.  Overall meantime 9 weeks were reported for bone unification. Titanium elastic nailing is more effective technique for patients less than 10 years old. Mean unification time of bone was less among them with little compliactions. 

scholarly journals A 5-year Overview of Forearm Fracture Etiology and Treatment Options in 7-15 Years Old Children

2012 ◽  
Vol 12 (1) ◽  
pp. 36-40
Author(s):  
Janis Upenieks ◽  
Sintija Sloka ◽  
Aigars Petersons ◽  
Anita Villerusa
Keyword(s):  
Closed Reduction ◽  
Bone Fractures ◽  
Pediatric Population ◽  
Forearm Fractures ◽  
Fractures In Children ◽  
Forearm Bones ◽  
The Moment ◽  
Wire Osteosynthesis ◽  
Methods Of Treatment ◽  
Plaster Immobilization

SummaryIntroduction.Forearm fractures make up a significant part of overall fracture rate in pediatric population, especially in 7-15 years old children. Different methods of treatment have been used, depending on the age of children and type and localization of fracture. Most controversies can be seen among conservative and surgical methods of treatment.Aim of the Study.The aim of our study is to identify common localizations and types of forearm bone fractures in pediatric population, as well as analyze patient data and treatment process depending on selected method of treatment for out-patients and in-patients.Materials and Methods.Retrospective analysis of out-patient and in-patient records, treated in University Children’s hospital from 2007 to 2011 was made, including first time patients with fractures of one or both forearm bones, according to ICD-10 codes S52.0- S52.9. Demographical data, trauma mechanisms, localization and type of fracture, as well as applied treatment and stay length at hospital were analyzed. 1742 out-patients and 1029 in-patients, 7-15 years old at the moment of trauma, were included in this research.Results.2771 forearm fractures were registered, 62.9% patients were treated on out-patient basis, 37.1 % patients required treatment in hospital. Forearm bone fractures were gender specific - 2235 boys and 536 girls had to be treated (Male:Female ratio was 4.2 : 1). The peak incidence was seen in 13 years old boys and girls. Boys suffered from forearm fractures more often in any age group. Most common mechanisms of injuries causing forearm fractures in children were related with sports trainings - 22.1%, skiing - 15.0% and traffic injuries - 10.0%. Most common activities at the moment of trauma differ by season - during winter months they include skiing, skating and sledging while in summer falls from height, bicycles and swings are dominant. Several trauma mechanisms, like sport trainings, are not season-dependent. Some injury mechanisms differ significantly by gender. Boys were more often as girls injured during sports trainings and skiing, while girls experience forearm fractures due to bicycling and skating. Occurrence of forearm fractures in children has seasonal differences with two peaks: from June to August and from December to February. Distal forearm fractures are the most often seen localization of overall forearm fractures (42 % in boys and 36 % in girls). In out-patients group conservative treatment was performed - plaster immobilization in 1339 cases and closed reduction, followed by plaster immobilization in 403 cases. In-patients were treated both - conservatively with immobilization in 21 cases and closed reduction in 188 cases, and surgically with K-wire osteosynthesis in 137 cases or elastic stable intramedullary nailing (ESIN) in 683 cases. The type and localization of each fracture, along with the age of patient, are the key factors for choosing the right treatment method. K-wire osteosynthesis was performed in all age groups for unstable fractures in distal or proximal third of forearm. ESIN was a method of choice for unstable or comminuted midshaft fractures of one or both bones, metadiaphyseal fractures and some specific conditions (radial neck fractures, Monteggia fractures-dislocations), especially in older patients. Stay length at hospital was ranging from 1 to 2 hospital days in case of immobilization (mean = 1,05 days), from 1 to 4 days in closed reduction group (mean = 1,32 days), but 1 to 12 days in hospital spent children after K-wire osteosynthesis (mean = 1,99 days) or ESIN (mean = 2,38 days).Conclusions.1. Forearm fractures in children have a significant gender diversity (M : F ratio is 4,2 : 1).2. Peak incidence group is 13 years old adolescents of both genders.3. Seasonality and season-specific injury patterns are typical for pediatric forearm fractures.4. The most common anatomic localization is the distal segment of forearm bones.5. Younger children (7-9 years) are mainly treated by conservative methods, while methods of choice for treatment of forearm fractures in adolescents (13-15 years) are operative.6. Surgical treatment of fractures do not significantly increase stay length at hospital.

scholarly journals Osteosynthesis with Kirschner wires in the treatment of unstable forearm fractures in children

2002 ◽  
Vol 55 (3-4) ◽  
pp. 140-145 ◽  
Author(s):  
Dusan Maric ◽  
Lazar Petkovic ◽  
Vladimir Tomasevic ◽  
Ljubomir Bajic ◽  
Djordje Gajdobranski ◽  
...  
Keyword(s):  
Forearm Fractures ◽  
Percutaneous Pinning ◽  
Older Children ◽  
Kirschner Wires ◽  
Manual Reduction ◽  
Fractures In Children ◽  
Short Period ◽  
Both Bones ◽  
Plaster Immobilization ◽  
Unstable Fractures

Introduction Forearm fractures make 13-18% of all injuries of the upper extremities in children. Most of them are older than 6 years. The degree of tolerance is different but children younger than 8 years can tolerate 15-20 degrees of angulation, 45 degrees of inadequate rotation and total displacement. Older children can tolerate angulation of10 degrees, 30 degrees of in adequate rotation and complete dislocation. Material and methods Over a period of five years (1995-2000) 54 children with forearm fractures (22 stable and 32 unstable fractures) were treated at the Pediatric Surgery Clinic in Novi Sad. Closed reduction and percutaneous pinning were treatments of choice in 19 patients with unstable fractures: 7 kids with only radius pinning, three kids with isolated ulnar fixation, 9 kids with pinning of both bones. Open reposition and fixation with Kirschner wires was done in 13 kids. Results In the group of 22 children with stable fractures results were excellent in 17 (77%), good in 4 (18.5%), and satisfactory in one child (4.5%). In the group of 32 children with unstable fractures excellent results were noted in 24 (75%), good in 4 (12.5%) satisfactory in 3 (9.4%) and unsatisfactory in one child (3.1%) Discussion A large number of forearm fractures in children can be treated with manual reduction and plaster immobilization into a tolerable position. However, in unstable fractures the method of choice is manual reduction with percutaneous pinning. Some authors prefer fixation of both bones, others fix only one. Conclusions Based on our experience it is concluded that orthopedic reposition and percutaneous pinning of unstable forearm fractures in children is very easy to perform, duration of intramedullar fixation is relatively short, removal of pins is also very easy without anesthesia and it requires short period of plaster immobilization. This provides faster rehabilitation and improves quality of life.

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