Elastic Stable Intramedullary Nail Fixation for Pediatric Forearm Bone Fractures: Outcomes and Complications Rate

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Published Nov 9, 2025
https://doi.org/10.62438/tunismed.v103i9.6022
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Vol. 103 No. 9 (2025): Tunis Med sept 2025

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Hamdi Kaziz
Orthopedics department, Mouwasat Hospital Dammam Eastern Province Kingdom of Saudi Arabia
Walid Balti
Orthopedics department, Mouwasat Hospital Dammam Eastern Province Kingdom of Saudi Arabia
Ahmad Charafeddine
Orthopedics department, Mouwasat Hospital Dammam Eastern Province Kingdom of Saudi Arabia
Mohammed Dardona
Orthopedics department, Mouwasat Hospital Dammam Eastern Province Kingdom of Saudi Arabia
Ilyes Elnnabigha El Maleh
Orthopedics department, Mouwasat Hospital Dammam Eastern Province Kingdom of Saudi Arabia
Fady Farouk
Orthopedics department, Mouwasat Hospital Dammam Eastern Province Kingdom of Saudi Arabia

Abstract

Background: Forearm shaft fractures are common among children. Elastic stable intramedullary nailing (ESIN) is generally considered the gold standard operative procedure. This study aimed to assess functional outcomes, axial alignment, bone healing, and complication rates in pediatric population.


Methods: This retrospective cohort study reviewed pediatric forearm fracture cases from January 2016 to December 2020 at Mouwasat Dammam Hospital, Saudi Arabia. The study included children aged 16 years and younger who were treated with elastic intramedullary nailing. Both clinical and radiological outcomes were assessed, along with the occurrence of complications.


Results: The study included 64 patients with a mean age of 8.3 years. In 60.93% of cases, both forearm bones were fractured, and in 60.09%, the fractures were located in the distal third of the forearm. Open reduction was needed in 20.03% of cases. None of the cases showed mean axial alignment values greater than 10°. The mean healing delay was 56.4 days, with a range of 38-73 days. The average time for nail removal was 4.5 months. From a clinical perspective, 92.18% of the cases (59 patients) had favorable outcomes. The complication rate was 23.43%.


Conclusion: ESIN has proven to be an effective method for stabilizing forearm fractures, ensuring proper alignment, promoting high union rates, and delivering satisfactory functional results. Although complications are relatively common, serious complications remain rare.

Keywords:

Elastic, Nail, Forearm, Fracture, Outcomes, Complications

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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