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Postoperative immobilization versus early mobilization following titanium elastic nailing in pediatric diaphyseal
Süleyman Kozlu1, Bilgehan Ocak1, Barış Görgün2
1Department of Orthopaedics and Traumatology, Faculty of Medicine, Kütahya Health Sciences University, Kütahya, Türkiye.
Purpose:
To compare the effects of postoperative splint immobilization versus early mobilization on 1-year radiological and functional outcomes in pediatric diaphyseal both-bone forearm fractures treated with elastic stable intramedullary nailing (ESIN).
Methods:
A retrospective analysis was performed on 124 children (6-14 years) who underwent ESIN for closed mid-diaphyseal radius-ulna fractures between January 2018 and December 2023. Patients were divided into splint (n = 64) and non-splint (n = 60) groups according to postoperative protocol. Radiological healing was evaluated using the Lane-Sandhu score at 1, 3, 6, and 12 months, and functional outcomes using the Price classification at 3, 6, and 12 months.
Results:
Baseline characteristics were comparable. At the third month, radiological scores were slightly higher in the splint group, while functional results favored early mobilization, though differences were not statistically significant. By the 6th and 12th months, complete union and excellent functional recovery were achieved in all patients, with no significant intergroup differences (p > 0.05).
Conclusions:
Early mobilization following ESIN is feasible and does not delay bone healing or impair function. Routine splinting may be unnecessary, and postoperative care can be tailored to the patient and fracture characteristics. Moreover, our findings demonstrate that when ESIN principles are properly applied, splint use in appropriately selected patients does not lead to any long-term functional deficit, and excellent outcomes can still be expected.
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