Surgical Management of Fracture Both Bone Forearm in Pediatric Using Elastic Stable Intramedullary Nail

Background: In children, forearm fractures are among the most prevalent types of fractures Operative procedures such as, pinning with K-wires, plate osteosynthesis as well as elastic-stable intramedullary nailing (ESIN) are necessary for these fractures. Objective: This study aimed to assess treating and outcomes of pediatric forearm fractures with elastic stable intramedullary nailing (ESIN). Patients and methods: At Orthopedic Departments of Zagazig University Hospital and Tripoli University Hospital, 8 skeletally immature patients with diaphyseal forearm fractures were studied in prospective cohort research. The study was carried out from November 2020 to May 2021. Pre-operative X-ray and CT were done and the patient was prepared for surgery. Elastic-stable intramedullary nailing technique was done to all patients, all patients were regularly followed clinically and radiographically for 1 week and then 2, 4, 6, 12 week after end of surgery. Results: we found that all patients progressed to union without the need for any further surgical intervention with good functional outcome as regards forearm rotation. One case had residual radius angulation more than 20 degree, no case had residual ulna angulation, 2 cases had superficial infection, 1 case had superficial radial nerve palsy and 1 case had elbow joint stiffness. Conclusion: Intramedullary fixation by flexible intramedullary nails (ESIN) is successful treatment option and recommended for pediatric patients with 4-14 years of age or older because it is simple safe and minimally invasive procedure and effective method of treatment that provides many biological and mechanical advantages.