Research Articles

Study of Titanium Elastic Nailing in Forearm Fractures in Elderly Patients

Abstract

Background: As operative techniques and the quality of implants are improving, surgical management of diaphyseal fractures of forearm bones in elderly patients is gaining widespread acceptance. Titanium elastic nailing system (TENS) provides flexural, axial, translational, and adequate rotational stability. This study aims to analyze the outcomes of the treatment of diaphyseal forearm bone fracture with TENS nail.
Methods: Elderly patients with both-bone forearm (BBFA) fractures in diaphysis were evaluated clinically and radiologically and followed for an average of six months. The outcome was assessed using the Grace-Eversmann scoring system. We followed up with all 25 patients and evaluated them every two weeks until the fracture united.
Results: After approval of the ethics committee, twenty-five elderly patients with AO type 22A3 and 22B3 fractures of the forearm bone who fulfilled the inclusion and exclusion criteria were taken for the study. The mean age of the participants was 65 years. The average time to bone union was 12 weeks, and the average surgery time was 35 minutes. There was a superficial infection in one case. Most patients had a full range of elbow and wrist movements after the union.
Conclusion: The TENS is an acceptable and good tachnique for displaced BBFA diaphyseal fractures in elderly patients. It is easy, cheap, and convenient and gives elastic mobility, promoting a rapid union of fractures and stability, which is ideal for early mobilization. It provides a lower complication rate, shorter surgery time, good cosmetic outcome, and easy implant removal.

1. Terry Canale S. Campbell's operative orthopaedics. 9th ed. St. Louis, MO: Mosby; 1998. p. 3425-41.
2. Schulte LM, Meals CG, Neviaser RJ. Management of adult diaphyseal both-bone forearm fractures. J Am Acad Orthop Surg. 2014;22(7):437-46. doi: 10.5435/JAAOS-22-07-437. [PubMed: 24966250].
3. Henle P, Ortlieb K, Kuminack K, Mueller CA, Suedkamp NP. Problems of bridging plate fixation for the treatment of forearm shaft fractures with the locking compression plate. Arch Orthop Trauma Surg. 2011;131(1):85-91. doi: 10.1007/s00402- 010-1119-y. [PubMed: 20521060].
4. Reilly TJ. Isolated and combined fractures of the diaphysis of the radius and ulna. Hand Clin. 2002;18(1):179-94. doi: 10.1016/s0749-0712(02)00014-8. [PubMed: 12143414].
5. Lee YH, Lee SK, Chung MS, Baek GH, Gong HS, Kim KH. Interlocking contoured intramedullary nail fixation for selected diaphyseal fractures of the forearm in adults. J Bone Joint Surg Am. 2008;90(9):1891-8. doi: 10.2106/JBJS.G.01636. [PubMed: 18762649].
6. Barry M, Paterson JM. A flexible intramedullary nails for fractures in children. J Bone Joint Surg Br. 2004;86(7):947-53. doi: 10.1302/0301-620x.86b7.15273. [PubMed: 15446515].
7. Johnson CW, Carmichael KD, Morris RP, Gilmer B. Biomechanical study of flexible intramedullary nails. J Pediatr Orthop. 2009;29(1):44-8. doi: 10.1097/BPO.0b013e3181911ee3. PubMed: 19098645].
8. Dietz HG, Schmittenbecher P, Illing P. Intramedulläre Osteosynthese im Wachstumsalte. Munich, Germany: Urban & Schwarzenberg; 1997. [In German].
9. Bellemans M, Lamoureux J. Indications for immediate percutaneous intramedullary nailing of complete diaphyseal forearm shaft fractures in children. Acta Orthop Belg. 1995;61(Suppl 1):169-72. [PubMed: 8623596].
10. Griffet J, el HT, Baby M. Intramedullary nailing of forearm fractures in children. J Pediatr Orthop B. 1999;8(2):88-9. [PubMed: 10218166].
11. Sebastin SJ, Chung KC. A historical report on Riccardo Galeazzi and the management of Galeazzi fractures. J Hand Surg Am. 2010;35(11):1870-7. doi: 10.1016/j.jhsa.2010.08.032. [PubMed: 21050967]. [PubMed Central: PMC4411960].
12. Grace TG, Eversmann WW. Forearm fractures: treatment by rigid fixation with early motion. J Bone Joint Surg Am. 1980;62(3):433-8. [PubMed: 7364814].
13. Patrick J. A study of supination and pronation, with especial reference to the treatment of forearm fractures. J Bone Joint Surg Am. 1946;28(4):737-48. [PubMed: 21003183].
14. Terry Canale S. Campbell's operative orthopaedics. 10th ed. St. Louis, MO: Mosby; 2002.
15. Lane WA. Some Remarks on the Treatment of Fractures. Br Med J. 1895;1(1790):861-3. doi: 10.1136/bmj.1.1790.861. [PubMed: 20755458]. [PubMed Central: PMC2509418].
16. Lambotte A. Technique and Indication of prostheses in the treatment of fractures [Technique et indication des prothèses dans le traitement des fractures]. Presse Med. 1909;17:321. [In French].
17. Schöne G. For the treatment of forearm fractures with bolting [Zur Behandlung von Vorderarmfrakturen mitBolzung]. Münch Med Wochenschr. 1913;60:2327-8. [In German].
18. Kapoor V, Theruvil B, Edwards SE, Taylor GR, Clarke NM, Uglow MG. Flexible intramedullary nailing of displaced diaphyseal forearm fractures in children. Injury. 2005;36(10):1221-5. doi: 10.1016/j.injury.2005.06.033. [PubMed: 16122749].
19. Ozkaya U, Kilic A, Ozdogan U, Beng K, Kabukcuoglu Y. Comparison between locked intramedullary nailing and plate osteosynthesis in the management of adult forearm fractures. Acta Orthop Traumatol Turc. 2009;43(1):14-20. [In Turkish]. doi: 10.3944/AOTT.2009.014. [PubMed: 19293611].
20. Khanna G, Sharma R. Elastic intramedullary nailing: An alternative in elderly osteoporotic forearm fractures. Int J Orthop Traumatol Surg Sci. 2017;3(Spec 1): 441-6.
Files
IssueVol 10 No 2 (2024) QRcode
SectionResearch Articles
DOI https://doi.org/10.18502/jost.v10i2.15539
Keywords
Forearm Fracture Fracture Fixation Elderly Intramedullary Nailing
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Sharma A, Suthar T, Sharma S, Sharma S. Study of Titanium Elastic Nailing in Forearm Fractures in Elderly Patients. J Orthop Spine Trauma. 2024;10(2):82-6.