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

Authors

  • Debanga S. Barua Department of Orthopedics, Assam Medical College and Hospital, Dibrugarh, Assam, India
  • Anuj Joon Department of Orthopedics, Assam Medical College and Hospital, Dibrugarh, Assam, India
  • Vaisakh A. Department of Orthopedics, Assam Medical College and Hospital, Dibrugarh, Assam, India
  • Tirupati S. Shirdinayak Department of Orthopedics, Assam Medical College and Hospital, Dibrugarh, Assam, India
  • Hari K. N. G. Department of Orthopedics, Assam Medical College and Hospital, Dibrugarh, Assam, India
  • Abhijit Das Department of Orthopedics, Assam Medical College and Hospital, Dibrugarh, Assam, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20214176

Keywords:

Both-bone forearm fracture, Intramedullary nailing, Open reduction, Internal fixation, Pediatrics

Abstract

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.

References

Landin LA. Fracture patterns in children. Analysis of 8,682 fractures with special reference to incidence, etiology and secular changes in a Swedish urban population 1950–1979. Acta Orthop Scand Suppl. 1983;202:1-109.

Worlock P, Stower M. Fracture patterns in Nottingham children. J Pediatric Orthop. 1986;6:656-60.

Bae D. Pediatric distal radius and forearm fractures. J Hand Surg. 2008;33:1911-23.

Patel A, Li L, Anand A. Systematic review: functional outcomes and complications of intramedullary nailing versus plate fixation for both-bone diaphyseal forearm fractures in children. Injury. 2014;45:1135-43.

Droll KP, Perna P, Potter J. Outcomes following plate fixation of fractures of both bones of the forearm in adults. J Bone Joint Surg Am. 2007;89:2619-24.

Henle P, Ortlieb K, Kuminack K. Problems of bridging plate fixation for the treatment of forearm shaft fractures with the locking compression plate. Arch Orthop Trauma Surg. 2011;131:85-91.

Sage FP. Medullary fixation of fractures of the forearm. A study of the medullary canal of the radius and a report of fifty fractures of the radius treated with a prebent triangular nail. J Bone Joint Surg Am. 1959;41:1489-516.

Van der Reis WL, Otsuka NY, Moroz P. Intramedullary nailing versus plate fixation for unstable forearm fractures in children. J Pediatr Orthop. 1998;18:9-13.

Visna P, Vlcek M, Valcha M. Management of diaphyseal forearm fractures using LCP angle- stable fixation devices and intramedullary nailing. Rozhl Chir. 2009;88:708-15.

Fracture and dislocation compendium. Orthopaedic trauma association committee for coding and classification. J Orthop Trauma. 1996;10:1-154.

Price CT, Scott DS, Kurzner ME, Flynn JC. Malunited forearm fractures in children. J Pediatr Orthoped. 1990;10(6):705-12.

Firl M, Wünsch L. Measurement of bowing of the radius. J Bone Joint Surg Br. 2004;86:1047-9.

Abdulkareem FM, Hwaizi L. Comparative Study between Elastic Nail Versus Plates and Screws in the Treatment of Diaphyseal Both Bone Forearm Fracture in Children. Indian J Public Health Res Develop. 2020;11(2).

Topak D, Doğar F, Yıldız M, Bilal Ö, Şakı Ö, Ekici E. Comparison of two different surgical treatments of forearm double diaphysis fractures in adolescents. Ann Clin Anal Med. 2020;11(5):457-61.

Thapa UJ, Wahegaonkar K, Ranjeet N, Sapkota K, Onta PR, Thapa P. Comparative study in the outcome of intramedullary nailing to plating for both-bone forearm fracture in early and mid-adolescent age group. Medical Journal of Dr. DY Patil Vidyapeeth. 2018;11(6):499.

Freese KP, Faulk LW, Palmer C, Baschal RM, Sibbel SE. A comparison of fixation methods in adolescent patients with diaphyseal forearm fractures. Injury. 2018;49(11):2053-7.

Teoh KH, Chee YH, Shortt N, Wilkinson G, Porter DE. An age-and sex-matched comparative study on both-bone diaphyseal paediatric forearm fracture. Journal of children's orthopaedics. 2009;3(5):367-73.

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Published

2021-10-26

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Original Research Articles