COMPLICATIONS OF INTRAMEDULLARY FIXATION OF PEDIATRIC FOREARM FRACTURES

A retrospective review of 20 children with forearm fractures heated wi th intramedullary fixation is presented. Indications for surgery inclu ded fracture malreduction, open fracture, polytrauma, unstable fractur e pattern, and compartment syndrome. Both radius and ulna were-fractur ed in 17 patients. Intramedullary fixation of both bones was performed in eight cases, ulna alone in nine, and isolated radius in three. A L imited open approach to one or both bones was necessary for insertion of the intramedullary rod in 15 of 20 cases, including the eight open fractures. Eighteen complications occurred in 10 of 20 patients, inclu ding hardware migration, infection, loss of reduction, reoperation, ne rve injury, significant decreased range of motion, synostosis, muscle entrapment, and delayed union. Despite the complications, 17 patients had excellent and two had good outcomes. Although excellent clinical r esults can be expected with intramedullary fixation, complications rel ated to the surgical technique can be expected.