COMPARATIVE ANALYSIS OF TREATMENTS FOR FOREARM FRACTURES IN CHILDREN: A SYSTEMATIC REVIEW AND META-ANALYSIS

Area of Science:

• Orthopedic Surgery
• Pediatric Orthopedics
• Evidence-Based Medicine

Background:

• Forearm fractures are common in children, requiring effective surgical fixation.
• Intramedullary fixation using TEN rods or Kirschner wires are common surgical options.
• Clinical outcomes and complication rates vary between fixation methods.

Purpose of the Study:

• To systematically review and compare clinical outcomes of intramedullary fixation with TEN rods versus Kirschner wires in pediatric forearm fractures.
• To assess adverse events, surgical time, and fracture consolidation time.
• To provide evidence for optimal treatment selection in pediatric forearm fractures.

Main Methods:

• Systematic literature review across Pubmed/Medline, Science Direct, and Scielo databases.
• Quality assessment of included trials using the MINORS tool.
• Meta-analysis of data from 16 selected studies (1,075 patients) using R software.

Main Results:

• Meta-analysis showed a significant increase in adverse events with TEN rods compared to Kirschner wires (RR 1.35).
• Surgical time was significantly reduced with TEN rods (mean difference -12.42 to -21.62 minutes).
• Fracture consolidation time showed a non-significant increase with TEN rods (mean difference 0.99). Moderate to high heterogeneity was observed (I² 73%).

Conclusions:

• Intramedullary fixation with TEN nails and Kirschner wires yields diverse clinical outcomes and complication profiles.
• The choice of fixation method requires careful consideration of patient-specific factors and fracture characteristics.
• Further research may be needed to clarify optimal fixation strategies given observed heterogeneity.