Tomasz Schwarz, Ewa Kotwicka-Jurczyk, Pascal Sturz, Piotr Janusz
{"title":"弹性髓内钉治疗前臂骨折的疗效。","authors":"Tomasz Schwarz, Ewa Kotwicka-Jurczyk, Pascal Sturz, Piotr Janusz","doi":"10.1097/BPO.0000000000003104","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>When surgical treatment is indicated, closed reduction with elastic stable intramedullary nailing (ESIN) is a widely accepted technique for managing both-bone forearm fractures in children. However, the optimal postoperative protocol-particularly the necessity and duration of immobilization-remains a matter of debate.</p><p><strong>Objective: </strong>This study aims to compare complication rates in patients with both-bone forearm fractures treated with ESIN, with or without postoperative splint immobilization.</p><p><strong>Methods: </strong>This retrospective study included 137 patients with displaced and unstable both-bone forearm shaft fractures who underwent surgical treatment with ESIN at our Department of Pediatric Surgery, Orthopedics, and Traumatology between January 2020 and August 2022. Postoperative immobilization was decided individually by the operating surgeon. Data collected included fracture etiology, healing time, complications, and final clinical outcomes.</p><p><strong>Results: </strong>Eighty-one patients were treated with postoperative splint immobilization, while 56 patients did not receive immobilization. There was no significant difference in bone healing time between the 2 groups. However, the complication rate was higher in the splinted group (16%) compared with the nonsplinted group (5.4%). In addition, open fractures and the need for open reduction were significantly associated with an increased risk of complications. No differences were observed between the groups in terms of QuickDASH scores.</p><p><strong>Conclusion: </strong>Postoperative splint immobilization does not appear to be necessary to achieve satisfactory outcomes following ESIN treatment of both-bone forearm fractures in pediatric patients. It does not influence bone healing time or functional recovery and may be associated with a higher risk of complications. Open fractures and the requirement for open reduction are additional factors associated with increased complication rates.</p><p><strong>Level of evidence: </strong>Level III-retrospective comparative study.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"To Splint or Not to Splint: Outcomes of Forearm Fracture Treatment With Elastic Intramedullary Nailing.\",\"authors\":\"Tomasz Schwarz, Ewa Kotwicka-Jurczyk, Pascal Sturz, Piotr Janusz\",\"doi\":\"10.1097/BPO.0000000000003104\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>When surgical treatment is indicated, closed reduction with elastic stable intramedullary nailing (ESIN) is a widely accepted technique for managing both-bone forearm fractures in children. However, the optimal postoperative protocol-particularly the necessity and duration of immobilization-remains a matter of debate.</p><p><strong>Objective: </strong>This study aims to compare complication rates in patients with both-bone forearm fractures treated with ESIN, with or without postoperative splint immobilization.</p><p><strong>Methods: </strong>This retrospective study included 137 patients with displaced and unstable both-bone forearm shaft fractures who underwent surgical treatment with ESIN at our Department of Pediatric Surgery, Orthopedics, and Traumatology between January 2020 and August 2022. Postoperative immobilization was decided individually by the operating surgeon. Data collected included fracture etiology, healing time, complications, and final clinical outcomes.</p><p><strong>Results: </strong>Eighty-one patients were treated with postoperative splint immobilization, while 56 patients did not receive immobilization. There was no significant difference in bone healing time between the 2 groups. However, the complication rate was higher in the splinted group (16%) compared with the nonsplinted group (5.4%). In addition, open fractures and the need for open reduction were significantly associated with an increased risk of complications. No differences were observed between the groups in terms of QuickDASH scores.</p><p><strong>Conclusion: </strong>Postoperative splint immobilization does not appear to be necessary to achieve satisfactory outcomes following ESIN treatment of both-bone forearm fractures in pediatric patients. It does not influence bone healing time or functional recovery and may be associated with a higher risk of complications. Open fractures and the requirement for open reduction are additional factors associated with increased complication rates.</p><p><strong>Level of evidence: </strong>Level III-retrospective comparative study.</p>\",\"PeriodicalId\":16945,\"journal\":{\"name\":\"Journal of Pediatric Orthopaedics\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-09-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Pediatric Orthopaedics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/BPO.0000000000003104\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pediatric Orthopaedics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/BPO.0000000000003104","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
To Splint or Not to Splint: Outcomes of Forearm Fracture Treatment With Elastic Intramedullary Nailing.
Introduction: When surgical treatment is indicated, closed reduction with elastic stable intramedullary nailing (ESIN) is a widely accepted technique for managing both-bone forearm fractures in children. However, the optimal postoperative protocol-particularly the necessity and duration of immobilization-remains a matter of debate.
Objective: This study aims to compare complication rates in patients with both-bone forearm fractures treated with ESIN, with or without postoperative splint immobilization.
Methods: This retrospective study included 137 patients with displaced and unstable both-bone forearm shaft fractures who underwent surgical treatment with ESIN at our Department of Pediatric Surgery, Orthopedics, and Traumatology between January 2020 and August 2022. Postoperative immobilization was decided individually by the operating surgeon. Data collected included fracture etiology, healing time, complications, and final clinical outcomes.
Results: Eighty-one patients were treated with postoperative splint immobilization, while 56 patients did not receive immobilization. There was no significant difference in bone healing time between the 2 groups. However, the complication rate was higher in the splinted group (16%) compared with the nonsplinted group (5.4%). In addition, open fractures and the need for open reduction were significantly associated with an increased risk of complications. No differences were observed between the groups in terms of QuickDASH scores.
Conclusion: Postoperative splint immobilization does not appear to be necessary to achieve satisfactory outcomes following ESIN treatment of both-bone forearm fractures in pediatric patients. It does not influence bone healing time or functional recovery and may be associated with a higher risk of complications. Open fractures and the requirement for open reduction are additional factors associated with increased complication rates.
Level of evidence: Level III-retrospective comparative study.
期刊介绍：
Journal of Pediatric Orthopaedics is a leading journal that focuses specifically on traumatic injuries to give you hands-on on coverage of a fast-growing field. You''ll get articles that cover everything from the nature of injury to the effects of new drug therapies; everything from recommendations for more effective surgical approaches to the latest laboratory findings.
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