PEDIATRIC FOREARM FRACTURES

FUNCTIONAL OUTCOME MANAGED WITH INTRAMEDULLARY RUSH NAILS - EXPERIENCE IN A TERTIARY CARE HOSPITAL

Abstract

Unstable forearm both bones fracture in children more than 10 years of age are
difficult to manage with cast and surgical intervention is required. Objectives: To determine the
functional outcome of patients with unstable forearm fractures managed with intramedullary
rush nail. Methods: This study was conducted at Department of Orthopedics, Civil Hospital
Karachi from July 2011 to August 2013. All the patients with age in between 10 to 15 years, with
close radius ulna unstable fracture presenting within 7 days of trauma or fall were included in
the study. All the fractures were stabilized with intramedullary rush nails. Functional outcome
was assessed at 12 weeks. Results: There were 79 patients included in the study. Mean age
was 13.17±2 years. There were 52 male patients (65.8%) and 27 females (34.2%). There were
24 patients with history of road traffic accident, 29 patients with fall and 26 patients with blunt
injury. Acceptable outcome was found in 64 (81%) patients and observed more in male children
(p=0.001) and children above 13 years of age (p=0.027). Union was achieved in all the patients.
Six patients had pin site irritation and 2 had superficial infection. Conclusions: Intramedullary
fixation with rush nail in unstable forearm fractures in the children appeared to be an effective
method of fixation and provided acceptable outcome in 64 (81%) patients.