Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025
The Legitimacy for the Use of Splint Immobilization After Elastic Intramedullary Nailing of Both-bone Forearm Shaft Fractures in Children.
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Kłosiński Stanisław, Synder Marek, Novriansyah Robin, Respati Danendra Rakha Putra, Borowski Andrzej
Аннотация
BACKGROUND: Pediatric diaphyseal both-bone forearm fractures are increasingly treated with elastic stable intramedullary nailing (ESIN) using titanium nails. However, clear guidelines on the type and duration of splint immobilization are lacking. This study aims to assess the necessity of splint immobilization after ESIN for diaphyseal forearm fractures in children.
METHODS: A prospective study was conducted on 38 patients with isolated radial and ulnar shaft fractures from 2018 to 2020. Patients were divided into two groups: 14 with splint immobilization for a mean of 3.93 weeks and 24 with only a sling allowing early postoperative movement. The mean ages were 10.3 years (group I) and 10.0 years (group II). Patients were evaluated at 2, 6, 12, and 24 weeks postsurgery. Final range of motion, recovery pace, bone healing, pain, complications, and treatment outcomes were compared.
RESULTS: No notable differences were found between splint immobilization and nonsplint groups regarding bone healing time (3.79 vs. 3.13 months), complications (28.6% vs. 29.2%), and final outcomes. Movement recovery was faster in the nonsplint group, but range of motion was similar at the final follow-up. Pain-free rates at 2 weeks postsurgery were higher in the splint group (85.8% vs. 50%). Pain intensity was similarly low in both groups (mean 2.5 vs. 2.67 on the visual analog scale scale).
CONCLUSION: Splint immobilization improves pain control in the first 2 weeks postsurgery, but it offers no additional benefits in terms of healing time and functional outcome. Meanwhile, ESIN is a safe, effective treatment for pediatric forearm shaft fractures.
METHODS: A prospective study was conducted on 38 patients with isolated radial and ulnar shaft fractures from 2018 to 2020. Patients were divided into two groups: 14 with splint immobilization for a mean of 3.93 weeks and 24 with only a sling allowing early postoperative movement. The mean ages were 10.3 years (group I) and 10.0 years (group II). Patients were evaluated at 2, 6, 12, and 24 weeks postsurgery. Final range of motion, recovery pace, bone healing, pain, complications, and treatment outcomes were compared.
RESULTS: No notable differences were found between splint immobilization and nonsplint groups regarding bone healing time (3.79 vs. 3.13 months), complications (28.6% vs. 29.2%), and final outcomes. Movement recovery was faster in the nonsplint group, but range of motion was similar at the final follow-up. Pain-free rates at 2 weeks postsurgery were higher in the splint group (85.8% vs. 50%). Pain intensity was similarly low in both groups (mean 2.5 vs. 2.67 on the visual analog scale scale).
CONCLUSION: Splint immobilization improves pain control in the first 2 weeks postsurgery, but it offers no additional benefits in terms of healing time and functional outcome. Meanwhile, ESIN is a safe, effective treatment for pediatric forearm shaft fractures.