J Korean Orthop Assoc.  2009 Aug;44(4):467-472.

The Internal Diameter of the Radius and Ulna in Korean Children

• Shin YW
• Yum JK
• Jung H
• Oh JS

Abstract

PURPOSE
Flexible intramedullary nailing is a advanced method for treating forearm fractures with fewer complications. But sometimes these nails should not be used due to the narrower internal diameter of the forearm bones. We studied the inner diameter of the radius and ulna of children along with their age in relation to the width of the nail. MATERIALS AND METHODS: We reviewed the forearm AP radiographs of all the patients who visited our institute during a specific period, in which their age was between 6 and 19. We measured the inner diameters of the radius and ulna at their narrowest location, and we analyzed the diameter in relation to the patients' age groups, and we compared this data with the width for the nail. RESULTS: A total of 208 patients was included in this study. The inner diameter grew with their increasing age, and the younger the patients, the higher was the rate of inappropriate use of the nail. On linear regression analysis, the age plus or minus 1 SD for usage of the ready-made nail was 12.6 years-old for the male radius. CONCLUSION: The nail was sometimes too thick for the diameter of the forearm bones of Korean children. It is correct for the surgeon to select whatever material to fix the fracture, but appropriate thickness of the nail should be selected thoughtfully in preoperative planning.

Keyword

Forearm bone fracture; Flexible intramedullary nail; Internal diameter measurement

MeSH Terms

Child
Forearm
Fracture Fixation, Intramedullary
Humans
Linear Models
Male
Nails
Radius
Ulna

Figure

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  Fig. 1 The lines show the narrowest points of internal diameter in the radius and ulna.

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  Fig. 2 The passable diameter for the bone is wider than the diameter of nail itself, with the tip bent for gliding against the endocortical surface.

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  Fig. 3 The graphs show distribution of the internal diameter of the radius in (A) mail and (B) female patients with the line of linear regression analysis. The line of limitation of passable thickness (3.5 mm) is crossed by the scatter plot line with -1 standard deviation from the average line, indicating appropriate age for using this device in about 84% of the population.

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