Abstract
Forearm shaft fractures are common injuries, often caused by falling from a fully upright standing position or falling off while riding a bike. These injuries can be treated nonoperatively or surgically with intramedullary nailing or plates. According to the literature, the method of choice for treating pediatric forearm shaft fractures is the application of elastic stable intramedullary nailing (ESIN)|. The study aimed to carry out a radiological assessment of ESIN use in pediatric patients with forearm shaft fractures, as well as an analysis of the etiology of the injury and the complication rate.
Patients aged 1 to 17 years, diagnosed with a fracture of the forearm shaft treated surgically with ESIN, with a set of X-ray pictures and a minimum 6-month follow-up qualified for the study. The evaluation of the axial alignment was carried out retrospectively in anatomical (AP) and lateral (LAT) positions. 402 radiographs of 201 patients (30,5% women, 69,5% men) with a mean age of 9.1 years (SD = 3.2) were analyzed. 68% of fractures occurred during sports activity. 75% of fractures involved both the radius and the ulna. The union was observed in 100% of cases. Mean axial alignment values in AP and LAT X-ray or both the ulna and radius were proper according to the literature.
Axial alignment values were not influenced significantly by the age, type of surgery carried out or the type of fracture. Plaster cast application (9,8% of cases) significantly influenced the values of radius axial alignment. Complications rate equaled 11.4% (n=23). The etiology of the injury did not affect axial alignment values. Significantly more complications were observed in the ORIF group (p = 0,0025).
The ESIN technique is an effective treatment for forearm diaphyseal fractures in children, with good radiological results regarding reduction and bone healing.