The Effect of Family Socioeconomic Status on the Outcomes of Titanium Elastic Nailing in Pediatric Both-Bone Forearm Fractures

Öz

Aim: This study aimed to evaluate the effects of parental socioeconomic status, including education and occupation levels, on bone healing and functional recovery in pediatric both-bone forearm fractures treated with titanium elastic nailing. Methods: A retrospective analysis was conducted on 84 pediatric patients (55 males, 29 females; mean age 9.7 ± 2.2 years) who underwent titanium elastic nailing fixation for both-bone forearm fractures between November 2022 and August 2024. Patients with open, pathological, or multiple fractures were excluded. Socioeconomic status was determined using a modified Hollingshead Index based on parental education and occupation. Clinical outcomes were assessed using Price criteria and goniometric measurements of elbow and wrist range of motion. Statistical analyses included the Mann–Whitney U, Kruskal–Wallis, and Spearman correlation tests. Results: All fractures achieved union, and no major complications such as nonunion or refracture were observed. Seven patients (8.3%) developed minor superficial wound infections, which resolved with conservative treatment. According to Price criteria, 52.4% of patients had excellent, 39.3% good, and 8.3% fair results. Higher socioeconomic levels were significantly correlated with better Price scores (p = 0.001) and decreased elbow extension loss (p = 0.007). There was no significant correlation between socioeconomic status and wrist flexion/ extension, elbow flexion range of motion. Conclusion: Higher parental socioeconomic status was associated with improved functional recovery, particularly in forearm rotation and elbow extension, following titanium elastic nailing fixation of pediatric forearm fractures. Emphasizing the importance of postoperative rehabilitation among families with lower socioeconomic levels may help prevent residual joint limitations.

Anahtar Kelimeler

• Pediatric forearm fracture
• Titanium elastic nail
• Socioeconomic status
• Functional outcome

Ailenin Sosyoekonomik Düzeyinin Pediatrik Önkol Kırıklarında Titanyum Elastik Çivileme Sonuçlarına Etkisi

Öz

Amaç: Bu çalışma, her iki ön kol kemiği kırığı nedeniyle titanyum elastik çivileme uygulanan pediatrik hastalarda ebeveynlerin sosyoekonomik durumunun, özellikle eğitim ve meslek düzeylerinin kemik kaynaması ve fonksiyonel iyileşme üzerindeki etkilerini değerlendirmeyi amaçladı. Yöntem: Kasım 2022 ile Ağustos 2024 tarihleri arasında her iki ön kol kemiği kırığı nedeniyle titanyum elastik çivi ile tespit edilen 84 pediatrik hasta (55 erkek, 29 kız; ortalama yaş 9,7 ± 2,2 yıl) retrospektif olarak incelendi. Açık, patolojik veya çoklu kırığı olan hastalar çalışma dışı bırakıldı. Sosyoekonomik durum, ebeveynlerin eğitim ve meslek düzeylerini temel alan modifiye Hollingshead İndeksi ile belirlendi. Klinik sonuçlar Price kriterleri, dirsek ile el bileği eklemlerinin gonyometri ile ölçülen hareket açıklığı ölçümleri kullanılarak değerlendirildi. İstatistiksel analizlerde Mann–Whitney U, Kruskal–Wallis ve Spearman korelasyon testleri uygulandı. Bulgular: Tüm olgularda kırık kaynaması sağlandı. Kaynamama veya tekrar kırık gibi majör komplikasyonlar gözlenmedi. Yedi hastada (%8,3) gelişen yüzeyel yara enfeksiyonları konservatif tedavi ile tamamen düzeldi. Price kriterlerine göre hastaların %52,4’ü mükemmel, %39,3’ü iyi ve %8,3’ü orta sonuçlara sahipti. Daha yüksek sosyoekonomik düzey, anlamlı olarak daha iyi Price skorları (p = 0,001) ve daha az dirsek ekstansiyon kaybı (p = 0,007) ile ilişkiliydi. Sosyoekonomik durum ile el bileği fleksiyon/ekstansiyonu veya dirsek fleksiyon hareket açıklığı arasında anlamlı bir ilişki saptanmadı. Sonuç: Daha yüksek ebeveyn sosyoekonomik düzeyi, titanyum elastik çivi ile tedavi edilen pediatrik ön kol kırıklarında fonksiyonel iyileşmenin, özellikle ön kol rotasyonu ve dirsek ekstansiyonu açısından daha iyi olmasına katkı sağlamaktadır. Düşük sosyoekonomik düzeye sahip ailelerde postoperatif rehabilitasyonun öneminin vurgulanması, eklem hareket kısıtlılıklarının önlenmesine yardımcı olabilir.

Anahtar Kelimeler

• Pediatrik önkol kırığı
• Titanyum elastik çivi
• Sosyoekonomik durum
• Fonksiyonel sonuç

Kaynakça

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