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Comparison of Pediatric Forearm Fracture Fixation Between Single- and Double-Elastic Stable Intramedullary Nailing
Sheng-Hu Du1, Yong-Zeng Feng, Yi-Xing Huang
1Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Insights
Single elastic stable intramedullary nailing (ESIN) for pediatric forearm fractures is as effective as double ESIN. This approach offers comparable outcomes with potentially lower costs and shorter surgery times.
Area of Science:
- Orthopedics
- Pediatric Surgery
- Traumatology
Background:
- Pediatric both-bone forearm fractures are common injuries.
- Elastic stable intramedullary nailing (ESIN) is a widely used fixation method.
- Comparing single- versus double-ESIN for these fractures requires further investigation.
Purpose of the Study:
- To evaluate and compare the outcomes of single-elastic stable intramedullary nailing (S-ESIN) and double-elastic stable intramedullary nailing (D-ESIN) for pediatric both-bone forearm fractures.
Main Methods:
- Retrospective analysis of 49 pediatric patients with both-bone forearm fractures treated with ESIN.
- Comparison between S-ESIN (radius fixation only) and D-ESIN (radius and ulna fixation).
- Evaluation of surgical duration, fluoroscopy time, hospitalization cost, cast duration, union time, radiographic outcomes, clinical results, and complications.
Main Results:
- S-ESIN group showed significantly lower surgical duration, fluoroscopy times, and hospitalization costs.
- The S-ESIN group had a longer period of cast removal but acceptable ulna angulation (<10 degrees).
- The D-ESIN group had a higher incidence of delayed ulna union; however, no significant differences in forearm motion loss or complication rates were observed between groups.
Conclusions:
- Single-ESIN fixation of the radius alone is an effective treatment for pediatric both-bone forearm fractures.
- S-ESIN demonstrates comparable clinical and radiographic outcomes to D-ESIN.
- S-ESIN is a viable and potentially preferred treatment option in the pediatric population.
Abstract:
The purpose of this study was to evaluate and compare the outcome of single- and double-elastic stable intramedullary nailing (ESIN) for the treatment of pediatric both-bone forearm fractures. We retrospectively analyzed 49 children with both-bone forearm fractures treated with ESIN. Twenty-four patients were treated with single-ESIN (S-ESIN) to fixate the radius only, and the other 25 patients were treated with double-ESIN (D-ESIN) to fixate the radius and ulna. The duration of surgery, times of fluoroscopy, cost of hospitalization, period of castoff, union time, radiographic outcomes, clinical results, and postoperative complications were compared. The duration of surgery, times of fluoroscopy, and cost of hospitalization were significantly lower in the S-ESIN group; however, the average period of castoff was longer in the S-ESIN group. The incidence of delayed union of the ulna was significantly higher in the D-ESIN than in the S-ESIN group. Although the mean angulation deformity of the ulna in the S-ESIN group was significantly larger than in the D-ESIN group, both of them were acceptable (<10 degrees). Despite this, there was no difference in the loss of forearm motion and complication rates between the 2 groups. In conclusion, our data suggest that S-ESIN to fixate the radius alone remains an equally effective fixation method in the pediatric population compared with both-bone fixation and is our treatment of choice.
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