RESULTS OF TITANYUM ELASTIC INTRAMEDULLARY NAILING (TEN) IN FOREARM FRACTURES IN CHILDREN; A RETROSPECTIVE ANALYSIS OF 23 CASES

Year 2012, Volume: 1 Issue: 2, 43 - 48, 30.08.2012

Gökhan Meriç , Bülent Kişin Mehmet Gem İhsan Şentürk Ali Engin Uysal

Abstract

OBJECTIVE: The treatment of fractures of the forearm between the detection of the most
exclusive method of conservative treatment with closed reduction and plaster. Surgical
treatment of forearm fractures intramedullary TEN method to be used frequently. We
evaluated the treatment results of forearm fractures in patients with intramedullary TEN.
METHODS: The study of TEN and intramedullary bone forearm fractures in 23 patients
followed for at least 1 year (2 female, 19 male, mean. Age 12.2; range 7-18 years) were
included. Functional and radiological follow-up examinations were performed. Price criteria
were used for the functional assessment of patients. Median follow-up 20.1 (range 12-
48months) months.
RESULTS: .21 out of 23 patients (91.3%) observed union. We have two patients with nonunion
achieved union with conservative treatment with plaster. Average time to union of fractures
2.6 (range 1.5-6 months) months. Pin-track infection in 4 cases (17.4%) of these patients
improved with antibiotherapy and debridement, 3 cases (12.9%) were developed sensory
branch of n. ulnaris palsy. 1 case (4.3%) extensor pollicis longus (EPL) rupture in with the
thumb extensor indicis propius tendon transfer to provided extension. 1 case (4.3%) wire
malposition observed. Functionally, 91.3% (21 cases) have achieved excellent results.
CONCLUSION: We think that, good functional outcome, easy application technique, and less
soft tissue injury when implant removal of forearm fractures in children due to lead practice in
the surgical treatment of intramedullary TEN is a good option

Keywords

pediatric forearm fractures, intramedullary nail

ÇOCUK ÖNKOL KIRIKLARININ CERRAHİ TEDAVİSİNDE KANAL-İÇİ ELASTİK ÇİVİLEME; 23 HASTANIN GERİYE DÖNÜK ANALİZİ

Abstract

AMAÇ: Önkol kırıklarının tedavisinde en seçkin yöntem kapalı redüksiyon ve alçı tespiti ile
uygulanan konservatif tedavidir. Cerrahi gereken önkol çift kırığı tedavisinde kanal-içi titanyum
elastik çivi(TEN) yöntemi sıklıkla kullanılmaktadır. Bizde önkol çift kırığı nedeniyle kanal-içi TEN
yapılan hastalarımızın tedavi sonuçlarını değerlendirdik.
YÖNTEMLER: Çalışmaya, önkol çift kırığı nedeniyle kanal-içi TEN yapılan ve en az 1 yıl süreyle
izlenen 23 hasta (2 kız,19 erkek; ort. yaş 12,2;dağılım7–18 yaş) alındı. Hastaların fonksiyonel
muayeneleri ve radyolojik takipleri yapıldı. Hastaların fonksiyonel değerlendirmesi Price
kriterlerine göre yapıldı. Ortalama takip süresi 20,1(dağılım 12-48ay)aydır.
BULGULAR: 23 hastanın 21’inde (%91,3) kaynama gözledik. Kaynamayan 2 hasta konservatif
alçı tedavisiyle kaynama elde ettik. Kırıkların ortalama kaynama süresi 2,6 (dağılım 1,5-6 ay)
aydır. Dört vakada pin dibi enfeksiyonu( % 17,4)gelişti bu hastalar antibiyoterapi ve debritman
ile iyileşti. Üç vakada n.ulnaris duyu dalı felci (% 12,9) gelişti. Ekstensör policis longus (EPL)
rüptürü gelişen 1 vakada (%4,3) ekstensör indicis propius tendon transferi ile başparmak
ekstansiyonu sağladık. 1 vakada(%4,3) tel malpozisyonu gözlemledik. Fonksiyonel olarak %91,3
(21 vaka) mükemmel sonuç elde ettik.
SONUÇ: Fonksiyonel sonuçlarının iyi olması, uygulama tekniğinin ve implant çıkartılmasının
kolay olması, daha az yumuşak doku hasarına yol açması nedeniyle çocuk önkol çift kırıklarının
cerrahi tedavisinde intramedüller TEN uygulamasının iyi bir seçenek olduğunu düşünüyoruz.

Keywords

çocuk önkol kırıkları, kanal-içi çivi

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