Surgical treatment of both-bones diaphyseal forearm fractures in children

Introduction: The treatment of children fractures of the forearm two bones aims to restore pronation-suppination. It is orthopedic in most cases but surgery has some indications. The aim of the study was to describe the surgical treatment modalities and to evaluate their effectiveness. Methods: A retrospective longitudinal study was carried out between January 1995 and July 2011 on 78 hospitalized patients in the Pediatric Orthopedic surgery department of Ibn Rochd university hospital. Results: The average age of patients was 9.2 years (SD = 3.1) with a male predominance. The left side was the most affected. Surgical treatment was decided after failure of conservative treatment, constituting 40.6% of the therapeutic processes. Sixty-eight children (87.2%) had a FIN (Flexible intramedullary nailing), one child was treated with a bone plate. The hospital stay averaged 3.5 days (SD = 2). The consolidation period was 11.5 weeks (SD = 2.1) and 57.1% of patients underwent a removal under general anesthesia after 12 months (SD = 6). The result was excellent or good in 47 cases (92.1%) and poor in 4 cases handled by FIN, otherwise excellent in the case of the bone plate. Discussion and Conclusion: Surgery allows the fixation of fractures that are inaccessible to orthopedic treatment especially in older children. The FIN is a simple technique with satisfactory postoperative course and good functional results.