Intramedullary nailing of forearm fractures in children

Forearm fractures are very common in children. They are usually treated orthopedically. For the last few years, Métaizeau's elastic stable nailing has been used in the authors' hospital. This study is based on 80 children with forearm fractures treated with intramedullary nailing: 64 boys and 16 girls, aged 6 to 16 (23 right sides, 58 left sides: 81 fractures). Nailing was performed 67 times for a displaced fracture, 3 times for a recurrent fracture, 3 times after a secondary displacement, and 7 times in patients with multiple injuries. Sound union was normally achieved in 78 patients, and normal motion in 79. Ten children experienced complications, but only complications involving the skin and sepsis were due to the technique. The seven skin complications (three in the ulnar fractures, and four in the radial fractures) consisted of three major local infections, one radial osteomyelitis, and three minor local nonunion of skin. One patient had limited thumb extension, and two patients fell a second time. One advantage of the method described here is that plaster casts are avoided, allowing children to go back to school early. Sound union is achieved as quickly as with orthopedic treatment, and recovery is excellent.