Entry point decision in intramedullary fixation of radial shaft fractures in paediatric population- Should we care?

Abstract

Children and adolescents are prone to diaphyseal both bone forearm or radial shaft fractures. The use of ESIN (Elastic stable intramedullary nailing) for intramedullary fixation is recommended in such fractures with significant angulation/malrotation. Comparative study of complications resulted by the two most common entry points: Lister’s entry point and lateral entry was done. We report a prospective one-year comparative study of seventeen patients who were operated with ESIN (Lister’s entry/Lateral entry) and complications were ascertained of either entry points using CHOP parameters.All seventeen patients underwent surgical intervention.Two out of eight cases with lister’s entry developed EI (Extensor indicis ) and EPL injury respectively whereas none of the patients with lateral entry showed any long term complications. No complications of infections, malunion or non-union was seen.We recommend using a lateral entry point based on our findings. Dorsal entry/Lister’s entry point complicating in extensor tendon injury often results in long term complications prolonging period of rehabilitation.