Minimally invasive treatment of double forearm fractures in children with elastic intramedullary nails

Objective To investigate the clinical efficacy and surgical techniques of elastic intramedullary nail in the treatment of double forearm fractures in children. Methods From March 2014 to July 2017, 12 children with double forearm fractures were treated with titanium elastic intramedullary nails. The elastic intramedullary nails were inserted from the distal radius and proximal ulna, and the affected limb was fixed with plaster over elbow and wrist for 4 to 6 weeks. When X-ray showed that the callus was well formed, the plaster was removed for functional exercise. The elastic intramedullary nails were removed after fracture healing. Results The closed reduction of radius and ulnar was performed in 7 and 8 cases respectively. The open reduction of radius and ulnar was performed in 5 and 4 cases respectively. The average length of incision at nail entry point was (1.17±0.17) cm. The average length of incision for open reduction was (1.54±0.29) cm. The operation time was (1.71±0.63) hours. The average amount of bleeding during operation was (12.92±7.53) ml. The postoperative follow-up period was 8 to 48 months, with an average of (23.58±11.42) months. The duration of bone healing was 3 to 8 weeks with an average of (4.92±1.38) weeks. The pronation angle of forearm was (83.75±6.44)°, and the supination angle was (85.83±5.15)°. The flexion and extension activities of elbow and wrist joints were similar to those of the healthy side. No complications such as nonunion, malunion, epiphyseal injury and needle tail irritation symptoms occurred in all the cases. Conclusion The application of titanium intramedullary nail is effective and minimally invasive in the treatment of double forearm fractures in children. Key words: Child; Forearm; Fractures,bone; Intramedullary nails