Daccache Elio Chahid, Bassil Georges Fayez, Badra Mohamad Ibrahim, Moucharafieh Ramzi Sharif
Department of Orthopedics and Traumatology, Faculty of Medicine, Lebanese American University, Beirut, Lebanon.
Department of Orthopedics and Traumatology, Faculty of Medicine, Lebanese University, Beirut, Lebanon.
J Orthop Case Rep. 2022 Oct;12(10):26-29. doi: 10.13107/jocr.2022.v12.i10.3352.
Pediatric both bone forearm fracture is a common injury in children. A multitude of current treatments are available, with Titanium Elastic Intramedullary Nail system becoming very popular. The advantages of this treatment are many; however, refracture of these nails in situ is a reported uncommon complication, and there is a paucity in the literature on the appropriate management in these cases.
An 8-year-old girl suffered from a left both bone forearm fracture after a fall from height, for which she was treated with the use of Titanium Elastic Intramedullary Nail system. Despite callus formation and fracture healing on X-rays, the nails were not removed at the intended time of 6 months due to the economic status of the country and the viral outbreak of COVID-19. Therefore, after 11 months of fixation, the patient presented again after a fall from height with the left both bone forearm refracture with the Titanium Elastic Intramedullary Nail system in situ. Intraoperative closed reduction was achieved with removal of the previous bent nails and refixation with new elastic nails. Follow-up of the patient 3 weeks later revealed satisfactory reduction with callus formation.
Pediatric both bone forearm refracture with Titanium Elastic Intramedullary Nail system in situ can be treated by gentle closed reduction and exchange nailing. This is not the first case to be managed with exchange nailing; however, it is one of the very few to have been treated as such and therefore these cases must be reported for further comparison with the different methods described in the literature to attain the optimal modality of treatment.
小儿双骨折前臂骨折是儿童常见的损伤。目前有多种治疗方法,钛弹性髓内钉系统变得非常流行。这种治疗方法有很多优点;然而,这些钉子原位再骨折是一种罕见的并发症,文献中关于这些病例的适当处理方法很少。
一名8岁女孩从高处坠落致左前臂双骨折,采用钛弹性髓内钉系统治疗。尽管X线显示有骨痂形成且骨折愈合,但由于该国的经济状况和新冠疫情爆发,原定6个月时未取出钉子。因此,固定11个月后,患者再次从高处坠落,导致左前臂双骨折,钛弹性髓内钉系统原位存在。术中通过取出先前弯曲的钉子并重新用新的弹性钉子固定,实现了闭合复位。3周后对患者进行随访,结果显示复位满意且有骨痂形成。
小儿双骨折前臂原位钛弹性髓内钉系统骨折可通过轻柔的闭合复位和更换钉子进行治疗。这不是第一例采用更换钉子治疗的病例;然而,这是极少数采用这种治疗方法的病例之一,因此必须报告这些病例,以便与文献中描述的不同方法进行进一步比较,以获得最佳治疗方式。