Paediatric diaphyseal forearm fractures: Is titanium elastic nailing a safe option?

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.

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Evaluation of Clinical Outcomes of Management of Pediatric Both Bone Forearm Fractures Using the Titanium Elastic Nailing System: A Prospective Study of 50 Cases

Journal of Orthopedics Traumatology and Rehabilitation ◽

10.4103/jotr.jotr_40_15 ◽

2020 ◽

Vol 12 (2) ◽

pp. 134

Author(s):

Rajesh Kapila ◽

Rakesh Sharma ◽

Ankush Chugh ◽

Mahesh Goyal

Keyword(s):

Prospective Study ◽

Clinical Outcomes ◽

Forearm Fractures ◽

Titanium Elastic Nailing ◽

System A ◽

A Prospective Study

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Pediatric forearm fractures with tens: freedom of movements

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20162841 ◽

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

Background: A prospective analysis of a case series of diaphyseal forearm fractures in children treated with titanium elastic nails is presented. Methods: 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.Results: 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.Conclusions: 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.

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Evaluation of Clinical Outcomes of Management of Paediatric Bone Forearm Fractures using Titanium Elastic Nailing System: A Prospective Study of 50 Cases

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2016/22040.8917 ◽

2016 ◽

Author(s):

Rajesh Kapila

Keyword(s):

Prospective Study ◽

Clinical Outcomes ◽

Forearm Fractures ◽

Titanium Elastic Nailing ◽

System A ◽

A Prospective Study

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Prospective Study of Surgical Management of Diaphyseal Fractures of Both Bones Forearm in Older Children Using Titanium Elastic Intramedullary Nailing at a Tertiary Care Hospital in Srikakulam

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/235 ◽

2021 ◽

Vol 8 (18) ◽

pp. 1223-1229

Author(s):

Dinesh Kumar Tutika ◽

Vamsi Krishna Kurmana ◽

Deepak Chamalla ◽

Shanmukha Rao Gollapalli ◽

Ranganath Marthala

Keyword(s):

Prospective Study ◽

Intramedullary Nailing ◽

Care Hospital ◽

Forearm Fractures ◽

Early Mobilisation ◽

Older Children ◽

Titanium Elastic Nailing ◽

Diaphyseal Fractures ◽

Both Bones ◽

Elastic Intramedullary Nailing

BACKGROUND Diaphyseal fractures of the forearm are one of the common fractures in the paediatric population. Closed reduction and cast immobilisation remain the standard treatment for paediatric diaphyseal forearm fractures owing to their unique remodelling potential. The main concern of conservative management is re-displacement of fracture in cast resulting in the unacceptable angular deformity in the forearm. Intramedullary fixation with titanium elastic nails for paediatric diaphyseal forearm fractures is becoming the trending surgical technique in those cases that warrant surgical intervention. The purpose of this study was to evaluate the functional outcome of the management of fracture of both bones forearm in the older children with titanium elastic nailing system. METHODS This was a prospective study done among thirty patients aged 5 to 16 years admitted to the Department of Orthopaedics at GEMS & Hospital, Ragolu, Srikakulam with diaphyseal fractures of both bones forearm from September 2017 to September 2019. We treated the patients by closed / open reduction and internal fixation with elastic stable intramedullary nailing. The patients were followed-up for six months. RESULTS We evaluated the patients clinically and radiologically after surgery. We assessed the outcome using modified Anderson’s AO criteria for forearm fractures extracted from the international journal of current pharmaceutical and clinical research functions. All fractures united at an average of 9.1 weeks without any delayed or non-union. The results were excellent in 86.6 % of patients and good in 13.3 % of patients without significant complications. There were minor complications in 6 patients (20 %). CONCLUSIONS Titanium elastic intramedullary nailing is a safe, effective and minimally invasive surgical method for treatment of displaced both bones forearm diaphyseal fractures in older children. This technique gives relative stability with a three-point fixation principle resulting in secondary bone healing by promoting early callus, ideal for early mobilisation. The technique offers several advantages, including minimal incision, preservation of fracture haematoma, dynamic axial stabilisation, and shorter hospitalisation. KEYWORDS Both Bone Fracture Forearm, Titanium Elastic Nailing System, Early Mobilisation

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A STUDY OF BOTH-BONE FOREARM FRACTURES IN PEDIATRIC POPULATION - TREATED BY ELASTIC STABLE INTRAMEDULLARY NAILING WITH TITANIUM ELASTIC NAILING SYSTEM

International Journal of Advanced Research ◽

10.21474/ijar01/10919 ◽

2020 ◽

Vol 8 (5) ◽

pp. 193-197

Author(s):

K. Usha Sree ◽

◽

B. Someswara Reddy ◽

Keyword(s):

Intramedullary Nailing ◽

Pediatric Population ◽

Elastic Stable Intramedullary Nailing ◽

Forearm Fractures ◽

Titanium Elastic Nailing

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Comparing titanium elastic nailing and plate osteosynthesis in treating both bone diaphyseal fractures of forearm in children

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20214176 ◽

2021 ◽

Vol 7 (6) ◽

pp. 1117

Author(s):

Debanga S. Barua ◽

Anuj Joon ◽

Vaisakh A. ◽

Tirupati S. Shirdinayak ◽

Hari K. N. G. ◽

...

Keyword(s):

Hospital Stay ◽

Plate Osteosynthesis ◽

Study Groups ◽

P Value ◽

Forearm Fractures ◽

Medical College ◽

Duration Of Hospital Stay ◽

Titanium Elastic Nailing ◽

Diaphyseal Fractures ◽

Operative Findings

Background: The present study aimed to compare the outcome of fixation of diaphyseal fractures of both bones of forearm using plate osteosynthesis (PO) and titanium elastic nail (TEN).Methods: This comparative non-randomized clinical trial was done on children aged 5 to 15 years, with diaphyseal fractures of both bone forearm fractures, operated and managed at the department of orthopedics, Assam Medical College and Hospital, Dibrugarh. Intra- and post-operative findings were compared between PO and TEN group patients.Results: Duration of hospital stay was significantly lower in patients in the TEN group (44.75±6.38 minutes) as compared to those in the PO group (69.71±5.91 minutes), p value <0.01. Similarly, duration of hospital stay was significantly lower in patients in the TEN group (5.01±0.67 days) as compared to those in the PO group (8.32±1.44 days), p value <0.05. Based on price criteria, 80% of the patients in the PO group and 85% in TEN group had excellent functional outcome. Radiological union time, maximum radial bow and location of maximal radial bow were found to be statistically similar in the two groups. Complication rate was similar in the two study groups.Conclusions: Based on the results of the present study, we conclude that both PO and TEN are be safely performed in children with diaphyseal both bone forearm fractures. With comparable functional and radiological outcomes, future studies are required before one technique can be recommended over the other.

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