A comparative study of titanium elastic nailing and plate osteosynthesis for pediatric both-bone diaphyseal forearm fractures
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20260004Keywords:
Both-bone forearm fracture, Plate osteosynthesis, Titanium elastic nailing, Pediatric orthopedics, Functional outcomeAbstract
Background: Both-bone diaphyseal forearm fractures are common in children and require stable fixation for optimal functional recovery. Plate osteosynthesis (PO) and titanium elastic nailing (TEN) are widely used surgical techniques. Comparative evidence on outcomes between these methods remains limited.
Methods: This multicentric, comparative study included 70 children aged 5-15 years with diaphyseal both-bone forearm fractures. Thirty-five patients underwent PO and 35 underwent TEN. Functional outcomes were assessed using the price criteria, and radiological union and radial bow restoration were evaluated. Operative duration, hospital stay, and complications were also recorded.
Results: Operative time and hospital stay were significantly shorter in the TEN group compared to PO. Functional outcomes were predominantly excellent in both groups, with no significant difference. Radiological union times and restoration of radial bow were comparable between groups. Complication rates were low and similar in both groups.
Conclusions: TEN provides equivalent functional and radiological outcomes to PO, with shorter surgery and hospitalization.
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References
Kontulainen S, Hughes J, Macdonald H, Johnston J. The biomechanical basis of bone strength development during growth. Med Sport Sci. 2007;51(R):13. DOI: https://doi.org/10.1159/000103002
Palvanen M, Kannus P, Parkkari J, Pitkäja¨ rvi T, Pasanen M, Vuori I, Järvinen M. The injury mechanisms of osteoporotic upper extremity fractures among older adults: a controlled study of 287 consecutive patients and their 108 controls. Osteoporosis Int. 2000;11(10):822-31. DOI: https://doi.org/10.1007/s001980070040
Kumar N. A Prospective Study of Surgical Management of Diaphyseal Fractures Both Bones Forearm in Children Using Elastic Stable Intra Medullary Nailing (Master's thesis, Rajiv Gandhi University of Health Sciences (India). 2016.
Patel A, Li L, Anand A. Systematic review: functional outcomes and complications of intramedullary nailing versus plate fixation for bothbone diaphyseal forearm fractures in children. Injury. 2014;45:1135-43. DOI: https://doi.org/10.1016/j.injury.2014.04.020
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. DOI: https://doi.org/10.2106/JBJS.F.01065
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. DOI: https://doi.org/10.1007/s00402-010-1119-y
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. DOI: https://doi.org/10.2106/00004623-195941080-00010
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 DOI: https://doi.org/10.1097/01241398-199801000-00003
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. DOI: https://doi.org/10.1097/01241398-199011000-00001
Firl M, Wünsch L. Measurement of bowing of the radius. J Bone Joint Surg Br. 2004;86:1047-9. DOI: https://doi.org/10.1302/0301-620X.86B7.14294
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):1117-21. DOI: https://doi.org/10.37506/v11/i2/2020/ijphrd/194977
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. DOI: https://doi.org/10.4328/ACAM.20253
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. Med J Dr. DY Patil Vidyapeeth. 2018;11(6):499. DOI: https://doi.org/10.4103/mjdrdypu.mjdrdypu_84_18
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. DOI: https://doi.org/10.1016/j.injury.2018.08.023
Teoh KH, Chee YH, Shortt N, Wilkinson G, Porter DE. An age-and sex-matched comparative study on both-bone diaphyseal paediatric forearm fracture. J Children's Orthopaed. 2009;3(5):367-73. DOI: https://doi.org/10.1007/s11832-009-0197-2