Outcome of Intramedullary Stainless steel Rush pins for the treatment  of Pediatric diaphyseal forearm bone fracture

Background & Objectives: Pediatric forearm bone fractures are common orthopedic injuries. Generally, these fractures can be successfully managed with closed reduction and casting however operative fixation may be required. Currently, the most common operative interventions are open reduction with plate fixation versus closed or open reduction with intramedullary fixation. Intramedullary fixation materials include Steinmann pins, Kirschner-wires, Rush pins, and elastic titanium nails. To demonstrate the outcome of Intramedullary Stainless steel Rush pins for the treatment of Pediatric diaphyseal forearm bone fracture.Materials & Methods: This study included thirty children with diaphyseal forearm bone fracture treated with intramedullary stainless steel rush pin. Patient’s age, sex, side, mode of injury, fracture type, fixation indication and method, time of clinical and radiological union, complication rate and final range of motion were evaluated at subsequent follow up. Clinical evaluation was done as per Price’s criteria. Results: Among 30 patients there were 22 boys (73.3%) and 8 girls (26.6%) with a mean age of 11.8 years (Range, 5 to14 years). Twenty (66.6%) patients had right forearm fracture, 10 (33.3%) patients had left forearm fracture. Union was obtained in a mean of 6.5±1.0 weeks (range 6 to 9 weeks). According to the criteria of Price et al. an excellent result was achieved in 25 patients (83.3%) and a good result in five patients (16.6%). Out of total 30 patients six (20%) had minor complications. Conclusion: Fixation with intramedullary stainless steel rush pin produces good to excellent results in diaphyseal forearm bone fractures in children. Based on our experience, rush pins are simple, safe, easily available and affordable to most of the patients in developing countries.JCMS Nepal. 2016;12(2):50-4

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Intramedullary Nailing for Paediatric Diaphyseal Forearm Bone Fracture

Kathmandu University Medical Journal ◽

10.3126/kumj.v9i3.6305 ◽

2012 ◽

Vol 9 (3) ◽

pp. 198-202 ◽

Cited By ~ 4

Author(s):

N P Parajuli ◽

D Shrestha ◽

D Dhoju ◽

G R Dhakal ◽

R Shrestha ◽

...

Keyword(s):

Functional Outcome ◽

Bone Fracture ◽

Closed Reduction ◽

Open Reduction ◽

Forearm Fracture ◽

Skin Irritation ◽

Pediatric Age Group ◽

Superficial Skin ◽

Reduction Methods ◽

Forearm Bone

Background Though most of the pediatric diaphyseal forearm bone fracture can be treated with closed reduction and cast application, indications for operative intervention in pediatric both-bone forearm fractures include open fractures, irreducible fractures, and unstable fractures. Controversy exists as to what amount of angulation, displacement, and rotation constitutes an acceptable reduction. Objective To review union time and functional outcome of pediatric diaphyseal forearm bone fracture managed with intramedullary rush pin by closed or open reduction. Methods Fifty patients with both bone fracture of forearm were treated with intramedullary rush pin by closed or open reduction were included in the study and followed up for minimum six months for radilological and functional outcome. Results Out of 50 patients, 31 underwent closed reduction and 19 underwent open reduction. All fractures maintained good alignment post operatively. Forty seven patients had excellent results with normal elbow range of motion and normal forearm rotation and three patients had good results. In all patients good radiological union was seen in three months time. Eight patients had minor complications including skin irritation over prominent hardware, backing out of ulnar pin, superficial skin break down with exposed hardware. Twenty-three (46%) patients had undergone implant removal at an average of 6 months (range 4-8 months) under regional or general anesthesia Conclusion Fixation with intramedullary rush pin for forearm fracture is an effective, simple, cheap, and convenient way for treatment in pediatric age group. DOI: http://dx.doi.org/10.3126/kumj.v9i3.6305 Kathmandu Univ Med J 2011;9(3):198-202

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The Operative Treatment of the shaft Fractures of the Forearm Bone: Operative Comparison in Intramedullary Fixation to Plate Fixation on Treatment of the Both Forearm Bone Fracture

Journal of the Korean Fracture Society ◽

10.12671/jksf.1998.11.1.63 ◽

1998 ◽

Vol 11 (1) ◽

pp. 63 ◽

Cited By ~ 2

Author(s):

Chung Nam Kang ◽

Jong Ho Kim ◽

Dong Wook Kim ◽

Young Do Gho ◽

Jae Doo You ◽

...

Keyword(s):

Operative Treatment ◽

Bone Fracture ◽

Plate Fixation ◽

Intramedullary Fixation ◽

Shaft Fractures ◽

Forearm Bone

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Clinical Comparison in Intramedullary Fixation to Plate Fixation on Treatment of the Both Forearm Bone Fractures

Journal of the Korean Fracture Society ◽

10.12671/jksf.1995.8.4.893 ◽

1995 ◽

Vol 8 (4) ◽

pp. 893 ◽

Cited By ~ 2

Author(s):

Seog Yeong Jeong ◽

Ung Moon ◽

Soo Jae Yim ◽

Seung Ryeol Yoon ◽

Soo Kyun Rah ◽

...

Keyword(s):

Bone Fractures ◽

Plate Fixation ◽

Intramedullary Fixation ◽

Clinical Comparison ◽

Forearm Bone

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Use of intramedullary implants in adult diaphyseal fracture both bone forearm

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20180522 ◽

2018 ◽

Vol 4 (2) ◽

pp. 243

Author(s):

Rajesh Kumar Jain ◽

Nitin Kiradiya

Keyword(s):

Success Rate ◽

Open Reduction ◽

Open Fracture ◽

Screw Fixation ◽

Excellent Result ◽

Forearm Fracture ◽

Operating Time ◽

Surgical Trauma ◽

Acceptable Result ◽

Operative Planning

Background: Fractures of the forearm bones are very common. The most common form of stabilization is plate and screw fixation. The role of Intramedullary nailing of fractures of the shafts of the adult radius and ulna is still to be defined. This study was perform to analyze anatomical and function outcome of the patients treated by Talwarkar square nail.Methods: We evaluated 46 patients (29 males and 17 females) had fracture both bone forearm treated by intramedullary nail. We analyzed patients in two broad group one with close fracture or grade I, II open fracture (34 patients) and other have open fracture grade IIIA or IIIB (12 patients). First group patients further analyzed weather close (22 patients) or open reduction (8 patients) required. Functional outcome was calculated by Grace and Eversman system.Results: Out of 32 patients of close fracture or open grade 1 or 2 fracture, 29 (90.62%) have excellent or acceptable result. All the patients (100%) in whom close reduction succeeds achieved excellent result. 22 (64.70%) patients close nailing possible.12 patients in whom open reduction required 9 (75%) goes into union. Close nailing have overall success rate is 90.62% where it fail and open nailing require success rate bring down to 75%.. Conclusions: IM nailing gives satisfactory results. Advantages of close nailing are- early union, low incidence of infection, small scars, less blood loss, short operating time with minimal surgical trauma, easier implant removal. Even though plate and screw fixation is the gold standard for stabilization of both bone forearm fracture but intramedullay implant can be used in selected cases with good result. To achieve acceptable result – early surgery, proper selection of the case, pre-operative planning, proper assessment of diameter, length and radial bowing of the nail, is required.

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Open Reduction and Plate Fixation of Femoral Shaft Fractures in Children Aged 4 to 10

Journal of Pediatric Orthopaedics ◽

10.1097/01241398-200303000-00011 ◽

2003 ◽

Vol 23 (2) ◽

pp. 190-193 ◽

Cited By ~ 5

Author(s):

Osman Tugrul Eren ◽

Metin Kucukkaya ◽

Caglar Kockesen ◽

Yavuz Kabukcuoglu ◽

Unal Kuzgun

Keyword(s):

Open Reduction ◽

Plate Fixation ◽

Femoral Shaft ◽

Femoral Shaft Fractures ◽

Shaft Fractures ◽

Fractures In Children

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Elastic stable intramedullary nailing in pediatric diaphyseal forearm bone fracture

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20170455 ◽

2017 ◽

Vol 3 (2) ◽

pp. 190

Author(s):

Poojan Kumar Rokaya ◽

Mangal Rawal ◽

Javed Ahmad Khan ◽

Praveen Kumar Giri

Keyword(s):

Intramedullary Nailing ◽

Bone Fracture ◽

Closed Reduction ◽

Forearm Fracture ◽

Minimal Invasive ◽

Elastic Stable Intramedullary Nailing ◽

Forearm Bones ◽

Average Loss ◽

Forearm Bone ◽

Elastic Intramedullary Nailing

Background: Pediatric forearm bone fracture present significant challenges where most of them are managed with closed reduction and casting. Irreducible, unstable and open fracture usually requires operative stabilization. Intramedullary nailing is considered minimal invasive however it is not free of complication. The aim of this study is to analyze the outcome and complications after elastic stable intramedullary nailing in pediatric diaphyseal forearm fracture.Methods: A descriptive observational study was carried out for four years (2013-2016) in diaphyseal pediatric forearm fracture stabilized with titanium elastic stable intramedullary nailing. Final range of motion, complications and outcome were assessed using Clavien-Dindo classification modification appropriate for orthopedic surgery.Results: We report the outcome of 36 patients with complete medical records. Closed reduction and nailing was successful in 25 patients (69.4%) whereas eleven patients (30.6%) required open reduction (both radius and ulna in 6 patients 16.7%, ulna in 3 patients 8.3% and radius in 2 patients 5.6%). Radiological union was achieved at an average of 7.75±1.5 weeks (range 6 to 16 weeks). Forearm rotation was limited in 7 patients with average loss of 16° pronation and 18° supination. The overall rate of complication was 22.2%. According to Clavien-Dindo classification excellent results were noted in 29 patients (80.6%), good in 3 patients (8.3%) and fair in 4 patients (11.1%). Conclusions: Elastic intramedullary nailing in pediatric diaphyseal forearm bones fracture is minimally invasive with low rate of complication and the outcomes are fair to excellent.

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Treatment of diaphyseal forearm fractures in children

Orthopedic Reviews ◽

10.4081/or.2014.5325 ◽

2014 ◽

Vol 6 (2) ◽

Cited By ~ 9

Author(s):

Matthew L. Vopat ◽

Patrick M. Kane ◽

Melissa A. Christino ◽

Jeremy Truntzer ◽

Philip McClure ◽

...

Keyword(s):

Current Literature ◽

Open Reduction ◽

Pediatric Population ◽

Plate Fixation ◽

Optimal Treatment ◽

Forearm Fractures ◽

Optimal Method ◽

Fractures In Children ◽

Soft Tissue Dissection ◽

Orthopedic Injuries

Both bone forearm fractures are common orthopedic injuries. Optimal treatment is dictated not only by fracture characteristics but also patient age. In the pediatric population, acceptable alignment can tolerate greater fracture displacement due to the bone’s ability to remodel with remaining growth. Generally, these fractures can be successfully managed with closed reduction and casting, however operative fixation may also be required. The optimal method of fixation has not been clearly established. Currently, the most common operative interventions are open reduction with plate fixation versus closed or open reduction with intramedullary fixation. Plating has advantages of being more familiar to many surgeons, being theoretically superior in the ability to restore radial bow, and providing the possibility of hardware retention. Recently, intramedullary nailing has been gaining popularity due to decreased soft tissue dissection; however, a second operation is needed for hardware removal generally 6 months after the index procedure. Current literature has not established the superiority of one surgical method over the other. The goal of this manuscript is to review the current literature on the treatment of pediatric forearm fractures and provide clinical recommendations for optimal treatment, focusing specifically on children ages 3-10 years old.

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