Assessment of proximal ulnar epiphyseal injuries in pediatric ulnar fractures treated by intramedullary nailing
Bülent Adil Taşbaş1, M Önder Delialioğlu1, Mustafa Ağar1, Bülent Dağlar1, Kenan Bayrakçı1, Deniz Cılız2, Uğur Günel1
1Ankara Numune Eğitim ve Araştırma Hastanesi, 4. Ortopedi ve Travmatoloji Kliniği
2Ankara Numune Eğitim ve Araştırma Hastanesi, Radyoloji Kliniği
Keywords: Bone nails; child; fracture fixation, intramedullary/ methods; radius fractures/surgery/radiography; range of motion, articular; ulna fractures/surgery/radiography.
Objectives: This study was designed to determine whether intramedullary nailing through the proximal ulnar epiphysis was associated with epiphyseal injuries in the long-term follow-up of pediatric diaphyseal radial and ulnar fractures.
Patients and methods: Fourteen patients (10 boys, 4 girls; mean age 9.2 years; range 6 to 12 years) were treated with intramedullary nailing for both-bone forearm fractures. The minimum follow-up was two years. The range of motion of the elbow and the wrist was compared with that of the normal side. Clinically and radiographically, length differences between the two forearms and the distance between the lateral epicondyle of the humerus and the radial styloid process were evaluated. The proximal ulnar epiphyses were compared by magnetic resonance images.
Results: Union was achieved in all the fractures within a mean of 6.9 weeks (range 5.8 to 10.5 weeks). None of the patients developed complications such as deep infection, synostosis, loss of reduction, vessel-nerve-tendon injuries, compartment syndrome, refractures, or implant migration. Second-degree pin tract infections seen in three patients were treated with antibiotic treatment. Clinically and radiographically, no length discrepancy was detected between the two forearms. Comparative direct radiographs and magnetic resonance images showed no signs of pathology involving the proximal ulnar epiphyses.
Conclusion: Our two-year follow-up data of pediatric ulnar fractures show that intramedullary nailing through the proximal ulnar epiphysis (olecranon) do not cause damage to the olecranon epiphysis.