Titanium Elastic Nailing System, An Effective Way Of Pediatric Forearm Fracture Management

Abstract

Introduction- Pediatric both bone forearm fracture commonly encountered in orthopedic emergency, their treatment varies widely from simple sling and cast to operative fixation with nailing and plating with no definitive consensus on one treatment modality. Although most of cases are satisfactorily managed with conservative measure, current innovation in elastic nailing, instrumentation and poor compliance to cast and frequent revisits to check the adequacy of reduction makes treatment with elastic titanium nailing an excellent means of intervention in unstable both bones fractures in children.Materials methods- The study was conducted at Dept of orthopedics, SHKM Govt medical college Nuh , India, which included 30 patients, 18 male, 12 female with age from 6 to 15years, with mean age of 10 years. Twenty patients had middle third fractures, 6 proximal 1/3rd and 3 distal 1/3rd fractures. Closed reduction was done in 24 (80%) patients and 6(20%) patients needed open reduction at # site.The transverse fractures were seen in 17 patients, oblique fractures in 6 patients, communicated in 4patients and spiral fractures in 3 patients. Results- The functional Outcome as per Price et al Criteria (7) was Excellent in 28 patients, good in 2 patients. None of the patients showed poor function at the final follow up at 1 year. Discussion and conclusion- Tens allows micro motion at fracture site due to elasticity of nails elastic deformation within the medullary canal creates a bending moment within the long bone that is not rigid, but that is stable enough to reduce and fix the fracture, and favors callous formation and bone healing. The treatment of pediatric both bones fractures with TENS continue to be the unparallel success and reliable treatment method with predictable outcome and minimal complication. We certainly recommend this type of treatment in angulated and unstable forearm fractures in children.