USE OF A SINGLE TITANIUM ELASTIC NAIL IN THE TREATMENT OF DIAPHYSEAL HUMERUS FRACTURES IN CHILDREN

Abstract

We reviewed eleven diaphyseal humerus fractures treated over an 18 month period, March 2004 to October 2005, using a single intramedullary Titanium Elastic Nail (TEN).

The mean age of 6 boys and 5 girls was 7.6 years. The longest follow up was twelve months. The mean period of implant insertion was 6 months. Diaphyseal fractures were most commonly the result of a fall (45%), and 3 (27%) were the result of motor vehicle accidents (MVA) with other associated injuries. Two (18%) were pathological fractures. All were closed fractures.

Nine of the eleven (81%) were treated by a closed reduction and a single retrograde TEN inserted percutaneously. Two required open reduction. There were no pre-operative or post-operative neurovascular complications. At mean follow up (6 months), there were ten satisfactory results (91%), with one complication of implant sepsis.

The use of TENs for diaphyseal humerus fractures in children has not been widely described in the literature as compared to their use for diaphyseal femoral fractures. Traditional teaching advocates conservative treatment for these fractures. We believe that in 4–12 year old patients, a single TEN is a viable option in the treatment of these fractures in that it gives over-all good results with minimal morbidity. It is easy, quick, allows early return to activities, and avoids some of the complications of conservative treatment such as those associated with prolonged immobilization and malunion.