Intramedullary nailing for diaphyseal forearm fractures in children after failed conservative treatment.

PURPOSE To evaluate treatment outcomes after intramedullary nailing using Ender nails for diaphyseal forearm fractures. METHODS 11 male and 9 female patients aged 6 to 15 (mean, 12) years underwent intramedullary nailing using Ender nails plus cast immobilisation for fractures of both the radius and ulna after conservative treatment had failed. RESULTS After a mean follow-up of 24 (range, 12-30) months, results were excellent in 14 patients, good in 5, and fair in one. None was poor. The mean operating time was 36 minutes. The mean time to bone union was 10 (range, 7-12) weeks. The mean time in the cast was 6 (range, 4-11) weeks. The mean time to implant removal was 8 (range, 6-10) months. All patients regained a full range of elbow movement, except in one who had limited supination and pronation (<20 degrees) due to a degree of malrotation. Two patients had pain owing to nail protrusion. One patient had a superficial infection. One patient had transient neurapraxia. CONCLUSION Intramedullary nailing using Ender nails plus cast immobilisation is effective for diaphyseal forearm fractures in children after conservative treatment has failed.