J Korean Orthop Assoc.  2012 Aug;47(4):250-256. 10.4055/jkoa.2012.47.4.250.

Operative Treatment of Pediatric Humeral Diaphyseal Fractures with Flexible Intramedullary Nails

Affiliations
  • 1Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
  • 2Department of Orthopedic Surgery, Inje University College of Medicine, Busan, Korea. kunbopark@gmail.com

Abstract

PURPOSE
Most humeral fractures of children are treated satisfactorily with conservative method, thus surgical treatment is often reserved for limited conditions. In cases of an open fracture, inadequate reduction or multiple traumas, children with humeral shaft fractures require operative treatment. The aim of our study was to evaluate results and complications of pediatric humeral shaft fractures that were treated with flexible intramedullary nails.
MATERIALS AND METHODS
A retrospective study was performed for 12 patients who were treated operatively by flexible intramedullary nails between March 2009 and September 2011. Surgical indications were an open fracture, an inability to maintain an adequate reduction, concomitant fractures, refractures and combined radial nerve injury. All patients were treated with 2 titanium flexible intramedullary nails by antegrade or retrograde techniques, according to the site of the fractures.
RESULTS
The mean follow-up period was 15 months, and all patients achieved union status without major complications. There were no neurovascular injuries or infection during surgical procedures. However, 4 patients showed irritation at the insertion site of the nail, and 2 of them underwent early removal of nails at about 6 weeks due to skin lesions as well as pain and discomfort. One boy showed a fracture next to the proximal insertion site of the antegrade nail. All patients showed a full range of motion, and went back to daily life by the final follow-up.
CONCLUSION
Flexible intramedullary nails are considered as a good option for the fracture of the pediatric humeral shaft. Surgeons should pay attention and use proper techniques to avoid complications.

Keyword

humerus; shaft; fracture; elastic nails
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