Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Orthopedic Surgery

Background: Both-bone diaphyseal forearm fractures are common injuries in the paediatric age group and are potentially unstable. The optimal method of fixation is still controversial. Both-bone hybrid fixation for these fractures is a new method of fixation, Which minimizes some of the disadvantages of elastic stable intramedullary nailing (ESIN) {uFB01}xation and incorporates some of the advantages of dual plate and screws {uFB01}xation. Aim: The purpose of this study was to evaluate feasibility, efficacy, advantages and disadvantages of hybrid fixation for management of both-bone diaphyseal forearm fractures in children aged between 10 and 16 years. Methods: We prospectively analyzed 30 children with both-bone forearm fractures treated with closed reduction and ESIN fixation for radius and open reduction and plate-screws fixation for ulna. The duration of surgery, times of fluoroscopy, union time, radiographic outcomes, clinical results, and complications were evaluated. Results: Our results showed that hybrid {uFB01}xation exhibited several advantages in terms of the duration of surgery, intraoperative use of {uFB02}uoroscopy, amount of intraoperative blood loss, duration of postoperative immobilisation, delayed union of the ulna and bone union time compared with other studies using one type of fixation in this age group. There were high rates of good and excellent functional outcomes and the complications rates were significantly low. Twenty four cases (80.0%) showed excellent outcome, 5 cases (16.7%) showed good outcome and only one case (3.3%) showed fair outcome. Conclusion: Hybrid {uFB01}xation is an acceptable, safe and effective alternative method for treatment of both-bone diaphyseal forearm fractures in skeletally immature patients aged between 10 and 16 years

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