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Intramedullary Nailing Versus Plate Fixation for Unstable Forearm Fractures in Children

Van der Reis, William L. M.D.; Otsuka, Norman Y. M.D.; Moroz, Paul M.D.*; Mah, Jung M.D.*

Journal of Pediatric Orthopaedics:
Trauma
Abstract

The purpose of this study was to compare the clinical and radiographic results of plate and screw fixation with intramedullary nailing for unstable fractures of the radius and ulna in children. We proposed that there was a statistically significant difference in the functional outcome and rate of complications between the two groups of patients. A retrospective analysis of 23 patients who were treated with plate-and-screw fixation and 18 who were treated with intramedullary nailing was performed. The average age was 10 years (range, 5-15). Indications for operative treatment included open fractures, irreducible fractures, and unstable fractures. Excellent results were obtained in 78% of patients in both groups at an average of 12 months after surgery. The functional results, rate of union, and rate of complications were statistically similar for the two groups. Intramedullary fixation allows short operative time, excellent cosmesis, minimal soft-tissue dissection, ease of hardware removal, and early motion after nail removal. Intramedullary fixation may provide a useful alternative for treatment of unstable fractures of the radius and ulna.

Author Information

From Children's Medical Center, University of California, San Francisco, California, U.S.A., and *Children's Hospital, McMaster University, Hamilton, Ontario, Canada.

Study conducted at Children's Medical Center, University of California, San Francisco, California, U.S.A.; and Children's Hospital, McMaster University, Hamilton, Ontario, Canada

Address correspondence and reprint requests to Dr. W. Van der Reis, Department of Orthopaedic Surgery, University of California, San Francisco, 500 Parnassus Ave., MU 320W, San Francisco, CA 94143, U.S.A.

© Lippincott-Raven Publishers.