Abstract
Objectives: To compare flexible intramedullary (IM) nailing with open reduction and internal fixation (ORIF) with plates and screws in the treatment of adolescent both-bone forearm fractures. Design: Retrospective comparative study. Setting: Level I trauma center. Patients/Participants: Sixty-one skeletally immature adolescents (mean age, 13.9 years; range, 11.5-16.9 years) treated operatively for both-bone forearm fractures from 1997 to 2007. Patients with Monteggia, Galeazzi, intra-articular, and pathologic fractures were excluded. Intervention: Forty-six patients (mean age, 14.1 years) underwent ORIF and 15 patients (mean age, 13.3 years) underwent flexible IM nailing. Main Outcome Measures: Time to fracture union, forearm rotation, magnitude and location of maximal radial bow, and complications. Results: There was no difference in mean time to union between the IM nailing (8.5 weeks) and ORIF (8.9 weeks) groups, although the study did not have sufficient power to detect a difference. Eighty-three percent of patients in both groups regained full forearm rotation. Although radial bow magnitude was comparably restored in both groups, the mean location of maximal radial bow was translated distally in the IM nailing group (67.2%) compared with the ORIF group (60.1%, P < 0.001) and a previously reported normal value (60.4%, P < 0.001). There were no major complications in the IM nailing group and five major complications in the ORIF group. Conclusions: Flexible IM nailing of both-bone form fractures in adolescents was safe and effective in our small series; we had less complications when compared with conventional ORIF. Although flexible IM nailing results in distal translation of the radial bow, forearm rotation is not compromised.
| Original language | English |
|---|---|
| Pages (from-to) | 440-447 |
| Number of pages | 8 |
| Journal | Journal of Orthopaedic Trauma |
| Volume | 24 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jul 1 2010 |
| Externally published | Yes |
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Keywords
- Adolescent
- Both-bone forearm fracture
- Intramedullary nailing
- Open reduction and internal fixation
ASJC Scopus subject areas
- Surgery
- Orthopedics and Sports Medicine
Cite this
Stabilization of adolescent both-bone forearm fractures : A comparison of intramedullary nailing versus open reduction and internal fixation. / Shah, Apurva S.; Lesniak, Bryson P.; Wolter, Troy D.; Caird, Michelle S.; Farley, Frances A.; Vander Have, Kelly L.
In: Journal of Orthopaedic Trauma, Vol. 24, No. 7, 01.07.2010, p. 440-447.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Stabilization of adolescent both-bone forearm fractures
T2 - A comparison of intramedullary nailing versus open reduction and internal fixation
AU - Shah, Apurva S.
AU - Lesniak, Bryson P.
AU - Wolter, Troy D.
AU - Caird, Michelle S.
AU - Farley, Frances A.
AU - Vander Have, Kelly L.
PY - 2010/7/1
Y1 - 2010/7/1
N2 - Objectives: To compare flexible intramedullary (IM) nailing with open reduction and internal fixation (ORIF) with plates and screws in the treatment of adolescent both-bone forearm fractures. Design: Retrospective comparative study. Setting: Level I trauma center. Patients/Participants: Sixty-one skeletally immature adolescents (mean age, 13.9 years; range, 11.5-16.9 years) treated operatively for both-bone forearm fractures from 1997 to 2007. Patients with Monteggia, Galeazzi, intra-articular, and pathologic fractures were excluded. Intervention: Forty-six patients (mean age, 14.1 years) underwent ORIF and 15 patients (mean age, 13.3 years) underwent flexible IM nailing. Main Outcome Measures: Time to fracture union, forearm rotation, magnitude and location of maximal radial bow, and complications. Results: There was no difference in mean time to union between the IM nailing (8.5 weeks) and ORIF (8.9 weeks) groups, although the study did not have sufficient power to detect a difference. Eighty-three percent of patients in both groups regained full forearm rotation. Although radial bow magnitude was comparably restored in both groups, the mean location of maximal radial bow was translated distally in the IM nailing group (67.2%) compared with the ORIF group (60.1%, P < 0.001) and a previously reported normal value (60.4%, P < 0.001). There were no major complications in the IM nailing group and five major complications in the ORIF group. Conclusions: Flexible IM nailing of both-bone form fractures in adolescents was safe and effective in our small series; we had less complications when compared with conventional ORIF. Although flexible IM nailing results in distal translation of the radial bow, forearm rotation is not compromised.
AB - Objectives: To compare flexible intramedullary (IM) nailing with open reduction and internal fixation (ORIF) with plates and screws in the treatment of adolescent both-bone forearm fractures. Design: Retrospective comparative study. Setting: Level I trauma center. Patients/Participants: Sixty-one skeletally immature adolescents (mean age, 13.9 years; range, 11.5-16.9 years) treated operatively for both-bone forearm fractures from 1997 to 2007. Patients with Monteggia, Galeazzi, intra-articular, and pathologic fractures were excluded. Intervention: Forty-six patients (mean age, 14.1 years) underwent ORIF and 15 patients (mean age, 13.3 years) underwent flexible IM nailing. Main Outcome Measures: Time to fracture union, forearm rotation, magnitude and location of maximal radial bow, and complications. Results: There was no difference in mean time to union between the IM nailing (8.5 weeks) and ORIF (8.9 weeks) groups, although the study did not have sufficient power to detect a difference. Eighty-three percent of patients in both groups regained full forearm rotation. Although radial bow magnitude was comparably restored in both groups, the mean location of maximal radial bow was translated distally in the IM nailing group (67.2%) compared with the ORIF group (60.1%, P < 0.001) and a previously reported normal value (60.4%, P < 0.001). There were no major complications in the IM nailing group and five major complications in the ORIF group. Conclusions: Flexible IM nailing of both-bone form fractures in adolescents was safe and effective in our small series; we had less complications when compared with conventional ORIF. Although flexible IM nailing results in distal translation of the radial bow, forearm rotation is not compromised.
KW - Adolescent
KW - Both-bone forearm fracture
KW - Intramedullary nailing
KW - Open reduction and internal fixation
UR - http://www.scopus.com/inward/record.url?scp=77955685160&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77955685160&partnerID=8YFLogxK
U2 - 10.1097/BOT.0b013e3181ca343b
DO - 10.1097/BOT.0b013e3181ca343b
M3 - Article
VL - 24
SP - 440
EP - 447
JO - Journal of Orthopaedic Trauma
JF - Journal of Orthopaedic Trauma
SN - 0890-5339
IS - 7
ER -