‘Failure’ of forearm intramedullary elastic nails

Mittal, RR; Hafez, M.; Templeton, Peter

doi:10.1016/j.injury.2003.10.029

Cited by 19 publications

(20 citation statements)

References 4 publications

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“…Muensterer and Regauer16 treated a refracture successfully with closed reduction and an above elbow plaster cast for a week. In the case described by Mittal et al 17 the 80° bent nail broke during reversed bending. The nails were replaced and the forearm was protected with an above elbow plaster cast for 6 weeks.…”

Section: Discussionmentioning

confidence: 92%

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Refractures of the paediatric forearm with the intramedullary nail in situ

et al. 2013

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Forearm fractures in children are common. When conservative treatment fails, internal fixation with Elastic Stable Intramedullary Nailing (ESIN) become the first choice in the operative treatment of diaphyseal forearm shaft fractures. Refractures with the intramedullary nail in situ are known to occur but formal guidelines to guide management in such fractures are lacking. We present a well-documented case of a radius midshaft refracture in a 12-year-old boy with the intramedullary nail in situ, managed by closed reduction. Literature is reviewed for this type of complication, the treatment of 30 similar cases is discussed and a treatment strategy is defined.The refracture of the paediatric forearm fracture with the intramedullary nail in situ is a rare, but probably under recognised complication which is observed in approximately 2.3% of the study population. Closed reduction may be considered in these cases.

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Section: Discussionmentioning

confidence: 92%

“…The intramedullary nails are usually removed 4–9 months postoperatively. Refractures after hardware removal may occur in up to 10% if removed earlier and are most commonly located in the midshaft 3 6 11 17. Also, non-union after early hardware removal is reported 12 22 23.…”

Section: Discussionmentioning

confidence: 99%

Refractures of the paediatric forearm with the intramedullary nail in situ

et al. 2013

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“…Beseitigung von Achsenfehlstellungen und Frakturstabilisation mit korrekter anatomischer Wiederherstellung und physiologische Aufspannung des interossären Raums, um Funktionsdefizite der Umwendbewegung zu verhindern [9,11]. Gipsverbandfreie Nachbehandlung [5,9]. Durchführung einer notwendigen Narkose [14].…”

Section: Operationsprinzip Und -Zielunclassified

“…• Sofortige postoperative Belastung möglich [2]. • Kein postoperativer Gipsverband erforderlich [5,9]. • Funktionelle Defizite äußerst selten [2].…”

Section: Operationsprinzip Und -Zielunclassified

Elastisch-stabile intramedulläre Marknagelung (ESIN) von Unterarmfrakturen

Weinberg

Castellani²,

Amerstorfer

2008

Orthop Traumatol

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Operative treatment of forearm shaft fractures with ESIN was analyzed in 77 children. Average duration of surgery was 44 min (10-140 min). After an average of 7 months (1-13 months), the nails were removed. Postoperative complications were analyzed in 74 patients (96%). In three patients (4%), a superficial pin site infection emerged. One child (1%) fell on his arm again and broke his distal radius during ESIN treatment, and one patient (1%) showed deflected nails after a refall on the arm 1 week after surgery. Assessment of functional outcome in 70 patients revealed only two cases (3%) with minimal functional deficit.

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“…These nails in paediatric forearms are usually removed 6-9 months post operatively as refracture may occur in 10% of cases if the nails are removed earlier. 7 There are no formal recommendations regarding the routine removal of metallic intramedullary nails in children, however, the approach of elective removal of nails in children is widely accepted. 8 As the incidence of refractures of the forearm with flexible intramedullary nails in situ is low, there are no formal guidelines for the management of this situation available.…”

Section: Discussionmentioning

confidence: 99%