THREE YEAR REVIEW OF FOREARM FRACTURE FIXATION WITH ELASTIC STABLE INTRAMEDULLARY NAILS

Abstract

The results of three years of treatment of children’s forearm fractures with flexible titanium nails was compared with the results from three original papers (Lascombes 1998, Richter 1998, Cullen 1998).

37 cases were identified using our trauma database and the main theatre database. 25 sets of case notes and x-rays were reviewed (age 4-16). The indication for fixation was fracture instability, either primarily or after initial conservative management. 6 cases were compound fractures. The fractures were reduced under general anaesthetic and then fixed using the ‘AO titanium elastic nail instrument and implant set’ (Synthes). 9 out of the 19 closed fractures needed to be opened for satisfactory reduction. Average theatre time was 104 minutes (25–165).

Average hospital stay was two days (1–4). 22 of the patients were immobilised in plaster of Paris for an average of 5 weeks. Nails were removed on average 4 months after insertion (1–10 months). 16% had minor complications which included transient nerve impairment, superficial infection and refracture. All patients were considered to be fully recovered when discharged.

Use of flexible nails in our district general hospital is comparable to previously published series in terms of case mix and complication rates.