Surgical Treatment of Diaphyseal Fractures of Both Forearm Bones in Adolescents

PURPOSE: To evaluate the results of surgical treatment for diaphyseal fractures of both forearm bones in adolescents. MATERIALS AND METHODS: Between March 2005 and February 2009, fifteen adolescents with diaphyseal fractures in both forearm bones were treated with a compression plate for the ulnar fractures and intramedullary pin fixation for the radial fractures. They were clinically and radiologically evaluated retrospectively. RESULTS: The mean time for radiological bone union was 9.2 weeks. At the last follow up, the rotational deformity and angulation were within seven degrees and evaluations of the functional results were excellent in all cases. One patient had a refracture of the ulna after plate removal, which was treated with a long-arm cast. CONCLUSION: The use of a compression plate for the ulnar fractures and intramedullary pin fixation for the radial fractures can be an effective method for unstable displaced diaphyseal fractures of both forearm bones in adolescents.

Surgical Treatment of Diaphyseal Fractures of Both Forearm Bones in Adolescents

PURPOSE: To evaluate the results of surgical treatment for diaphyseal fractures of both forearm bones in adolescents. MATERIALS AND METHODS: Between March 2005 and February 2009, fifteen adolescents with diaphyseal fractures in both forearm bones were treated with a compression plate for the ulnar fractures and intramedullary pin fixation for the radial fractures. They were clinically and radiologically evaluated retrospectively. RESULTS: The mean time for radiological bone union was 9.2 weeks. At the last follow up, the rotational deformity and angulation were within seven degrees and evaluations of the functional results were excellent in all cases. One patient had a refracture of the ulna after plate removal, which was treated with a long-arm cast. CONCLUSION: The use of a compression plate for the ulnar fractures and intramedullary pin fixation for the radial fractures can be an effective method for unstable displaced diaphyseal fractures of both forearm bones in adolescents.

Treatment of Diaphyseal Fractures of Forearm Both Bones: Comparison between Plate Fixation and Rush Pin Intramedullary Nailing

PURPOSE: To compare the functional results between the plate fixation and Rush pin insertion for the treatment of diaphyseal fractures of the forearm both bones. MATERIALS AND METHODS: We reviewed 51 patients who were treated for diaphyseal fractures of the both forearm bones from 1995 to 2003, and evaluated them with Anderson's method. Eighteen patients were treated with plate fixation of both bones (group I), 14 patients treated with of the Rush pin insertion of the radius and plate fixation of the ulna (group II), 11 patients treated with plate fixation of the radius and Rush pin insertion of the ulna (group III), and 8 patients treated with Rush pin insertion of forearm both bones (group IV). RESULTS: Seventeen out of eighteen cases obtained favorable result (94.4%) in group I, 12 out of 14 cases (85.7%) in group II, 7 out of 11 cases (63.3%) in group III, and 4 out of 8 cases (50.0%) in group IV with statistically significant differences between the groups (p=0.04). CONCLUSION: Plate fixation of forearm both bones yield the best result. Thus, plate fixation of both forearm bones is recommended in treating the diaphyseal fractures of both forearm bones. At least one bone is recommended to be fixed with a plate if it is not possible to fix both forearm bones with plates.

Flexible Intramedullary Pin Fixation of Both Forearm Bone Fractures in Children

PURPOSE: To evaluate the efficacy of Flexible intramedullary pin fixation in pediatric forearm diaphyseal fractures. MATERIALS AND METHODS: In this retrospective study, we reviewed 15 cases of forearm diaphyseal fractures operated using flexible intra-medullary nail fixation technique between January 2000 and December 2004. Of these 15 children, there were 11 boys and 4 girls with an average age of 11.6 years (range, 7~15 years). The implants were introduced in the distal radius and proximal ulna in all patients. An average duration of fixation was 5.3 months in the radius, 4.7 months in the ulna. After operation, all patient were applied with a long arm cast and the duration of immobilization was 5.2 weeks (range, 4~6 weeks) on average. RESULTS: All fractures in this series healed with normal range of supination (average 80.0) and pronation (average, 71.6 degrees). Average operation time including anesthesia was 123 minutes and hospital stay was 5.4 days. Time to union was 8.4 weeks on average. Range of motion and functional results were satisfactory in all cases. There were one case of incomplete ulnar nerve injury and two cases of refracture which were treated conservatively without any permanent complication. CONCLUSION: Flexible intramedullary pin fixation technique is a good method in case of unstable displaced fracture and difficult or failed closed treatment.

Reduction of Pediatric Forearm Diaphyseal Fractures by Pin Leverage Technique

PURPOSE: Although the majority of children's forearm diaphyseal fractures may be treated conservatively with closed reduction and cast immobilization, unstable or irreducible fractures are usually treated by surgical management. Authors performed percutaneous pin leverage reduction technique for irreducible displaced diaphyseal fractures. The aim of this study is to determine the efficacy of pin leverage technique in pediatric forearm diaphyseal fractures MATERIALS AND METHODS: In this retrospective study, we reviewed 22 cases of forearm diaphyseal fractures reduced by percutaneous pin leverage technique between 1997 and 2002. We analyzed radiographs, operation time, hospital stay and immobilization period, range of motion, postoperative complications and functional results by Thomas. RESULTS: Average length of follow up was 28 months with mean age of 10.5 years. All fractures in this series healed less than 2 degrees of diaphyseal angulation. Average operation time including anesthesia was 42 minutes and hospital stay was 4.6 days. Time to union was 49.6 days in average and range of motion and functional results were satisfactory in all cases except one case of congenital radioulnar synostosis. There was one case of superficial pin track infection as complication. CONCLUSION: In operative treatment of children's diaphyseal fractures of forearm bones, percutaneous pin leverage reduction technique is a good alternative method prior to open reduction in case of difficult closed reduction.