THE INDICATIONS OF INTRAMEDULLARY NAILING IN CHILDREN’S FRACTURES WITH NANCY NAILS

Abstract

The type and the location of the fractures of the long bones in children that can be treated by elastic intra-medullary nailing are described in this study.

Fourty-one patients (aged from 5–18 years old) were treated in our department with fractures of the long bones located on the metaphysis or diaphysis (5 on the distal third of radious and ulna ,8 diaphyseal fractures of the forearm ,7 diaphyseal fractures of the tibia ,5 of the distal end of tibia ,6 of the femoral diaphysis,7 on the distal end of femur and 3 on the diaphysis of the humerus).

All operations were performed under radiological control ,to avoid any damage of the growth plates. Tibial , femoral and humeral fractures were fixed with 2 nails whereas forearm fractures were reducted with one nail.

Postoperative immobilization with a long cast was applied in forearm fractures at least for 4 weeks.

The follow-up time ranged from 1–3 years. The following clinical findings were noticed at the examination : skin infection at the point of the nail insertion area (3 patients), limitation of the range of movements at the carpal joint (2 patients).

Radiological findings showed satisfactory callus formation at an early stage in all cases and rotational deformity in 2 femoral obligue fractures due to insufficient stabilization.

According to our clinical and radiological findings the results were excellent in 34 cases and good in 7 cases.

Fractures of the diaphysis or metaphysis of the long bones in children are fully indicated for intramedullary nailing with elastic nails and the postoperative complications are minor when the fractures are not close to the growth plates.

The method is not indicated for comminuted or oblique fractures and fractures – separations.