ĐÁNH GIÁ KẾT QUẢ ĐIỀU TRỊ GÃY KÍN THÂN HAI XƯƠNG CÁNH TAY Ở TRẺ EM BẰNG PHƯƠNG PHÁP KẾT XƯƠNG KÍN ĐINH NỘI TỦY ĐÀN HỒI DƯỚI MÀN TĂNG SÁNG

Abstract

Introduction: Both bone forearm fractures are common orthopedic injuries in fractures, accounting for about 40% of injuries in children. The most popular management for these fractures is closed reduction associating with percutaneous insertion of elastic intramedullary nail on fluoroscopy. Objective: Evaluation of the results treatment both bone diphyaseal fractures in children by closed reduction and percutaneous insertion of elastic intramedullary nailing on fluoroscopy. Subjects and Methods: This is a descriptive study of 86 patients (from 4 to 16 years old) with both bone diphyaseal fractures in children by closed reduction and percutaneous insertion of elastic intramedullary nailing on fluoroscopy at Dong Anh genaral hospital between January 2020 to March 2024. Results: Mean age: 12.8 ±2.3 (4-16), mainly 11-16 years old (60.5%) and 63.9% of the patients were males. Traffic accidents and daily–life accidents account for the highest percentage of injuries with 81,4%. According to the AO classification, the A class is 40,7%, the B class is 44,2% and the C class is 15,1%. Closed reduction successful in 96.5%, 3.5% of cases were failed to align by closed reduction and had to undergo open fixation. Nails used for one bone ≥ 2 accounted for 97.7% and using 1 nail for one bone accounted for 2.3%. 81.4% of cases took less than 45 minutes in operation room (OR). 45 – 60 minutes: 11.7% and > 60 minutes: 6.9%. Post – operative X-ray, the anatomic results of post-operation were 83.7% non-displaced, 15.1% less displaced and 1.2% highly displaced. No secondary displacement was recorded, 3 case superficial infection. Union was achieved in 100% subjects. The outcomes were anatomically and functionally evaluated rating system, 80 patients (93%) were excellent and good and none had unacceptable results. Conclusions: Closed reduction associating with percutaneous insertion of multiple elastic intramedullary nail is a nonviolent method of treatment for both-bone diaphyseal forearm fractures with large displacement in children. Use of this treatment results in predictable good results in both anatomical and functional acceptance. It also illustrates low complication rates and remarkable healing outcomes fix the fracture firmly, create conditions for early rehabilitation after surgery and bring good results to the patient.