O2083 SURGICAL TREATMENT OF UNSTABLE DISPLACED FOREARM FRACTURES IN CHILDREN BY SMOOTH INTRAMEDULLARY PINS

Abstract

Aims: A retrospective study was performed in order to evaluate the results of þxation of displaced unstable fractures of both bones of the forearm in children by intramedullary pins. Methods: 121 children (5–16 year old; mean 11 years) with unstable displaced midshaft fractures of the forearm were treated by smooth intra-medullary pin þxation. 75 (62%) were operated upon primarily because of an irreducible fracture. 46 (38%) were operated upon within 2 weeks after failed closed reduction. The arm was immobilized in a plaster cast extending above the elbow for about 6 weeks. Pins were removed between 6 weeks to 5 years (average 5.5 months). Results: Follow up (1Ð15 years; mean 5.5 years) was available in 91/121 children. Using the grading scheme of Price, functional results at follow up were excellent in 79/91 (87%) and good in 12/91 (13%). There were no fair or poor results. 80 Pts (88%) had within one year a full range of movement of the elbow and wrist joints. 11 Pts (12%) had an average loss of 10 degree of supination. 4 Pts. had a mild degree of angulation of the distal third of the forearm. 2 Pts had a temporary neuro-praxia of the interosseous nerves. 2 Pts had re-fractures following early removal of pins. There was one case of non union treated successfully by plating. One of the patients had a delayed union of 6 months until solid healing. One had a deep wound infection. There were no other complications. Conclusions: In conclusion we found that smooth intramedullary pinning for displaced midshaft fractures of the forearm in children is a good, simple and safe method.