Research Article
BibTex RIS Cite

Close Reduction and Intramedullary Elastic Nailing in Pediatric Both Bone Forearm Fractures. Clinical and Radiological Results.

Year 2022, Volume: 3 Issue: 1, 11 - 16, 12.03.2022
https://doi.org/10.48176/esmj.2022.47

Abstract

Introduction: Intramedullary nailing with titanium elastic nails (TEN) is the most commonly used method in the surgical treatment of pediatric both bone forearm fractures. In the present study, it was aimed to evaluate the clinical and radiological results of patients who underwent closed reduction and intramedullary nailing with TEN.
Methods: The study was planned retrospectively, and a total of 30 (4 girls, 26 boys) patients were included. Demographic characteristics and radiographic findings of the patients were evaluated with archive records. Clinical results were evaluated based on Price criteria.
Results: The mean age of the patients was 10.5 (5-14, sd:1.97) years and the mean follow-up time was 45 (30-86, sd:15.9) months. The mean time to bony union was 6.9 (5-12, sd:1.66) weeks. According to Price criteria, 25 patients had excellent results and 5 patients had good results. Complete union of both radius and ulna bone was achieved in all patients. Skin irritation at the ulna insertion site of TEN developed in three patients, and superficial radial nerve palsy developed in one patient. It was observed that all four patients who developed complications completely recovered at the last control.
Conclusion: According to the results of the present study, closed reduction and intramedullary nailing with TEN is a reliable method with low complication and high success rates in the surgical treatment of pediatric both bone forearm fractures.

References

  • 1. Naranje SM, Erali RA, Warner WC, Sawyer JR, Kelly DM. Epidemiology of pediatric fractures presenting to emergency departments in the United States. J Pediatr Orthop 2016;36(4):45-8.
  • 2. Ryan LM, Teach SJ, Searcy K, Singer SA, Wood R, Wright JL et al. Epidemiology of pediatric forearm fractures in Washington. J Trauma 2010;69(4):200-5.
  • 3. Noonan KJ, Price CT: Forearm and distal Radius fractures in children. J Am Acad Orthop Surg 1998;6(3):146-56.
  • 4. Pace JL. Pediatric and adolescent forearm fractures: current controversies and treatment reccommendations. J Am Acad Orthop 2016;24(11):780-8.
  • 5. Price CT, Scott DS, Kurzner ME, Flynn JC. Malunited forearm fractures in children. J Pediatr Orthop 1990;10(6):705-12.
  • 6. Qidwai SA. Treatment of diaphyseal forearm fractures in children by intramedullary Kirschner wires. J Trauma 2001;50(2):303-7.
  • 7. Garg NK, Ballal MS, Malek IA, Webster RA, Bruce CE. Use of elastic stable intramedullary nailing for treating unstable forearm fractures in children. J Trauma 2008;65(1):109-15.
  • 8. Kapila R, Sharma R, Chugh A, Goyal M. Evaluation of clinical outcomes of management of paediatric both forearm fractures using titanium elastic nailing system: A prospective study of 50 cases. J Clin Diag Res 2016;10(11):12-5.
  • 9. Şahin N, Akalın Y, Türker O, Özkaya G. ESIN and K-wire fixation have similar results in pediatric both-bone diaphyseal fractures. Ulus Trav Acil Cerrahi Derg 2017;23(5):415-20.
  • 10. Adam O, David VL, Horhat FG, Boia ES. Cost-effectiveness of titanium elastic nail (TEN) in the treatment of forearm fractures in children. Medicana (Kaunas) 2020;15;56(2):79.
  • 11. Shah AS, Lesniak BP, Wolter TD, Caird MS, Farley FA, Vander Have KL: Stabilization of adolescent both-bone forearm fractures: A Comparison of intramedullary nailing versus open reduction and internal fixation. J Orthop Trauma 2010;24(7):440-7.
  • 12. Lascombes P, Prevot J, Ligier JN et al. Elastic stable intramedullary nailing in forearm shaft fractures in children: 85 cases. J Pediatr Orthop 1990;10:167-71.
  • 13. Du SH, Feng YZ, Huang YX, Guo XS, Xia DD. Comparison of pediatric forearm fracture fixation between single- and double-elastic stable intramedullary nailing. Am J Ther 2016;23(3):730-6.
  • 14. Myers GJ, Gibbons PJ, Glithero PR, Nancy nailing of diaphyseal forearm fractures. Single bone fixation for fractures of both bone. J Bone Surg Br 2004;86:581-4.
  • 15. Crighton EA, Huntley JS. Single versus double intramedullary fixation of paediatric both bone forearm fractures: Radiological outcomes. Cureus 2018;10(4):2544.
  • 16. Lyman A, Wegner D, Landin L. Pediatric diaphyseal forearm fractures: epidemiology and treatment in an urban population during a 10-year period, with special attention to titanium elastic nailing and its complications. J Pediatr Orthop B 2016;25(5):439-46.
  • 17. Norgaard SL, Riber SS, Danielsson FB, Pedersen NW, Viberg B. Surgical approach for elastic stable intramedullary nail in pediatric radius shaft fracture: a systematic review. J Pediatr Orthop B 2018;27(4):309-14.
  • 18. Han B, Wang Z, Li Y, Xu Y, Cai H. Risk factors for refracture of the forearm in children treated with elastic stable intramedullary nailing. Int Orthop 2019;43(9):2093-2097.
  • 19. Lobo-Escolar A, Roche A, Bregante J, Gil-Alvaroba J, Sola A, Herrera A. Delayed union in pediatric forearm fractures. J Pediatr Orthop 2012;32(1):54-7.
  • 20. Antabak A, Luetic T, Ivo S, et al. Treatment outcomes of both- bone diaphyseal paediatric forearm fractures. Injury 2013; 44:11-5.
  • 21. Makki D, Matar HE, Webb M, Wright DM, James LA, Ricketts DM. Elastic stable intramedullary nailing in paediatric forearm fractures: the rate of open reduction and complications. J Pediatr Orthop B 2017; 26: 412-6.
  • 22. Kocadal O, Pepe İM, Yolaçan H, Ceritoğlu KU, Ergün C, Güneş Z ve ark. Pediatrik önkol kırıklarının intramedüller elastik çivi ile tedavisi. SDÜ Tıp Fakültesi Dergisi 2017;23(4):0-0.

Çocuk Önkol Çift Kemik Kırıklarında Kapalı Redüksiyon ve Kanal-içi Elastik Çivileme. Klinik ve Radyolojik Sonuçlar

Year 2022, Volume: 3 Issue: 1, 11 - 16, 12.03.2022
https://doi.org/10.48176/esmj.2022.47

Abstract

Giriş: Çocuk önkol çift kemik kırıklarının cerrahi tedavisinde titanyum elastik çiviler (TEÇ) ile kanal-içi çivileme en sık kullanılan yöntemdir. Bu çalışmada kapalı redüksiyon ve TEÇ ile kanal-içi çivileme yapılan hastaların klinik ve radyolojik sonuçlarının değerlendirilmesi amaçlandı.
Yöntemler: Çalışma geriye-dönük olarak planlandı ve toplam 30 (4 kız, 26 erkek) hasta dahil edildi. Hastaların demografik özellikleri ve radyografik bulguları arşiv kayıtları ile değerlendirildi. Klinik sonuçlar için Price kriterleri baz alındı.
Bulgular: Hastaların yaş ortalaması 10.5 (5-14, ss:1.97) yıl ve ortalama takip süresi 45 (30-86, ss: 15,9) ay idi. Kaynama süresi ortalaması 6,9 (5-12, ss:1.66) hafta idi. Price kriterlerine göre 25 hastada mükemmel, 5 hastada iyi sonuç mevcut idi. Tüm hastalarda hem radius hem ulna kemiğinde tam kaynama sağlandı. Üç hastada TEÇ’nin ulna giriş yerinde cilt basısı, bir hastada ise yüzeyel radial sinir hasarı gelişti. Komplikasyon gelişen dört hastanın da son kontrolde tamamen iyileştiği gözlendi.
Sonuç: Yapmış olduğumuz bu çalışmanın sonuçlarına göre kapalı redüksiyon ve TEÇ ile kanal-içi çivileme çocuk önkol çift kemik kırıklarının cerrahi tedavisinde düşük komplikasyon ve yüksek başarı oranları ile güvenilir bir yöntemdir.

References

  • 1. Naranje SM, Erali RA, Warner WC, Sawyer JR, Kelly DM. Epidemiology of pediatric fractures presenting to emergency departments in the United States. J Pediatr Orthop 2016;36(4):45-8.
  • 2. Ryan LM, Teach SJ, Searcy K, Singer SA, Wood R, Wright JL et al. Epidemiology of pediatric forearm fractures in Washington. J Trauma 2010;69(4):200-5.
  • 3. Noonan KJ, Price CT: Forearm and distal Radius fractures in children. J Am Acad Orthop Surg 1998;6(3):146-56.
  • 4. Pace JL. Pediatric and adolescent forearm fractures: current controversies and treatment reccommendations. J Am Acad Orthop 2016;24(11):780-8.
  • 5. Price CT, Scott DS, Kurzner ME, Flynn JC. Malunited forearm fractures in children. J Pediatr Orthop 1990;10(6):705-12.
  • 6. Qidwai SA. Treatment of diaphyseal forearm fractures in children by intramedullary Kirschner wires. J Trauma 2001;50(2):303-7.
  • 7. Garg NK, Ballal MS, Malek IA, Webster RA, Bruce CE. Use of elastic stable intramedullary nailing for treating unstable forearm fractures in children. J Trauma 2008;65(1):109-15.
  • 8. Kapila R, Sharma R, Chugh A, Goyal M. Evaluation of clinical outcomes of management of paediatric both forearm fractures using titanium elastic nailing system: A prospective study of 50 cases. J Clin Diag Res 2016;10(11):12-5.
  • 9. Şahin N, Akalın Y, Türker O, Özkaya G. ESIN and K-wire fixation have similar results in pediatric both-bone diaphyseal fractures. Ulus Trav Acil Cerrahi Derg 2017;23(5):415-20.
  • 10. Adam O, David VL, Horhat FG, Boia ES. Cost-effectiveness of titanium elastic nail (TEN) in the treatment of forearm fractures in children. Medicana (Kaunas) 2020;15;56(2):79.
  • 11. Shah AS, Lesniak BP, Wolter TD, Caird MS, Farley FA, Vander Have KL: Stabilization of adolescent both-bone forearm fractures: A Comparison of intramedullary nailing versus open reduction and internal fixation. J Orthop Trauma 2010;24(7):440-7.
  • 12. Lascombes P, Prevot J, Ligier JN et al. Elastic stable intramedullary nailing in forearm shaft fractures in children: 85 cases. J Pediatr Orthop 1990;10:167-71.
  • 13. Du SH, Feng YZ, Huang YX, Guo XS, Xia DD. Comparison of pediatric forearm fracture fixation between single- and double-elastic stable intramedullary nailing. Am J Ther 2016;23(3):730-6.
  • 14. Myers GJ, Gibbons PJ, Glithero PR, Nancy nailing of diaphyseal forearm fractures. Single bone fixation for fractures of both bone. J Bone Surg Br 2004;86:581-4.
  • 15. Crighton EA, Huntley JS. Single versus double intramedullary fixation of paediatric both bone forearm fractures: Radiological outcomes. Cureus 2018;10(4):2544.
  • 16. Lyman A, Wegner D, Landin L. Pediatric diaphyseal forearm fractures: epidemiology and treatment in an urban population during a 10-year period, with special attention to titanium elastic nailing and its complications. J Pediatr Orthop B 2016;25(5):439-46.
  • 17. Norgaard SL, Riber SS, Danielsson FB, Pedersen NW, Viberg B. Surgical approach for elastic stable intramedullary nail in pediatric radius shaft fracture: a systematic review. J Pediatr Orthop B 2018;27(4):309-14.
  • 18. Han B, Wang Z, Li Y, Xu Y, Cai H. Risk factors for refracture of the forearm in children treated with elastic stable intramedullary nailing. Int Orthop 2019;43(9):2093-2097.
  • 19. Lobo-Escolar A, Roche A, Bregante J, Gil-Alvaroba J, Sola A, Herrera A. Delayed union in pediatric forearm fractures. J Pediatr Orthop 2012;32(1):54-7.
  • 20. Antabak A, Luetic T, Ivo S, et al. Treatment outcomes of both- bone diaphyseal paediatric forearm fractures. Injury 2013; 44:11-5.
  • 21. Makki D, Matar HE, Webb M, Wright DM, James LA, Ricketts DM. Elastic stable intramedullary nailing in paediatric forearm fractures: the rate of open reduction and complications. J Pediatr Orthop B 2017; 26: 412-6.
  • 22. Kocadal O, Pepe İM, Yolaçan H, Ceritoğlu KU, Ergün C, Güneş Z ve ark. Pediatrik önkol kırıklarının intramedüller elastik çivi ile tedavisi. SDÜ Tıp Fakültesi Dergisi 2017;23(4):0-0.
There are 22 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Research Articles
Authors

Zeynel Mert Asfuroğlu 0000-0001-8796-4133

Ahmet Küçük 0000-0001-5244-4250

Nusret Köse 0000-0002-1517-9635

Publication Date March 12, 2022
Published in Issue Year 2022 Volume: 3 Issue: 1

Cite

APA Asfuroğlu, Z. M., Küçük, A., & Köse, N. (2022). Çocuk Önkol Çift Kemik Kırıklarında Kapalı Redüksiyon ve Kanal-içi Elastik Çivileme. Klinik ve Radyolojik Sonuçlar. Eskisehir Medical Journal, 3(1), 11-16. https://doi.org/10.48176/esmj.2022.47
AMA Asfuroğlu ZM, Küçük A, Köse N. Çocuk Önkol Çift Kemik Kırıklarında Kapalı Redüksiyon ve Kanal-içi Elastik Çivileme. Klinik ve Radyolojik Sonuçlar. Eskisehir Med J. March 2022;3(1):11-16. doi:10.48176/esmj.2022.47
Chicago Asfuroğlu, Zeynel Mert, Ahmet Küçük, and Nusret Köse. “Çocuk Önkol Çift Kemik Kırıklarında Kapalı Redüksiyon Ve Kanal-içi Elastik Çivileme. Klinik Ve Radyolojik Sonuçlar”. Eskisehir Medical Journal 3, no. 1 (March 2022): 11-16. https://doi.org/10.48176/esmj.2022.47.
EndNote Asfuroğlu ZM, Küçük A, Köse N (March 1, 2022) Çocuk Önkol Çift Kemik Kırıklarında Kapalı Redüksiyon ve Kanal-içi Elastik Çivileme. Klinik ve Radyolojik Sonuçlar. Eskisehir Medical Journal 3 1 11–16.
IEEE Z. M. Asfuroğlu, A. Küçük, and N. Köse, “Çocuk Önkol Çift Kemik Kırıklarında Kapalı Redüksiyon ve Kanal-içi Elastik Çivileme. Klinik ve Radyolojik Sonuçlar”, Eskisehir Med J, vol. 3, no. 1, pp. 11–16, 2022, doi: 10.48176/esmj.2022.47.
ISNAD Asfuroğlu, Zeynel Mert et al. “Çocuk Önkol Çift Kemik Kırıklarında Kapalı Redüksiyon Ve Kanal-içi Elastik Çivileme. Klinik Ve Radyolojik Sonuçlar”. Eskisehir Medical Journal 3/1 (March 2022), 11-16. https://doi.org/10.48176/esmj.2022.47.
JAMA Asfuroğlu ZM, Küçük A, Köse N. Çocuk Önkol Çift Kemik Kırıklarında Kapalı Redüksiyon ve Kanal-içi Elastik Çivileme. Klinik ve Radyolojik Sonuçlar. Eskisehir Med J. 2022;3:11–16.
MLA Asfuroğlu, Zeynel Mert et al. “Çocuk Önkol Çift Kemik Kırıklarında Kapalı Redüksiyon Ve Kanal-içi Elastik Çivileme. Klinik Ve Radyolojik Sonuçlar”. Eskisehir Medical Journal, vol. 3, no. 1, 2022, pp. 11-16, doi:10.48176/esmj.2022.47.
Vancouver Asfuroğlu ZM, Küçük A, Köse N. Çocuk Önkol Çift Kemik Kırıklarında Kapalı Redüksiyon ve Kanal-içi Elastik Çivileme. Klinik ve Radyolojik Sonuçlar. Eskisehir Med J. 2022;3(1):11-6.