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Intramedullary Fixation of Both Bone Forearm Fractures in Children and Adolescents: Healing Correlates With Development of the Olecranon Apophysis
Journal article   Peer reviewed

Intramedullary Fixation of Both Bone Forearm Fractures in Children and Adolescents: Healing Correlates With Development of the Olecranon Apophysis

Martin J Morrison, 3rd, Joshua N Speirs, Anne M Chicorelli, Matthew Garner, John Jack M Flynn and Martin J Herman
Journal of pediatric orthopaedics, v 40(3), pp e198-e202
Mar 2020
DOI: https://doi.org/10.1097/BPO.0000000000001419
PMID: 31219914
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Adolescent Bone and Bones - diagnostic imaging Child Female Forearm Injuries - diagnosis Forearm Injuries - surgery Fracture Fixation, Intramedullary - adverse effects Fracture Fixation, Intramedullary - instrumentation Fracture Fixation, Intramedullary - methods Fracture Healing Fractures, Bone - diagnostic imaging Fractures, Bone - surgery Humans Male Olecranon Process - diagnostic imaging Olecranon Process - injuries Olecranon Process - surgery Patient Selection Radiography - methods Reoperation Retrospective Studies
The purpose of this study was to determine whether healing of both bone forearm (BBFA) fractures in children and adolescents is associated with the stage of the olecranon apophysis development as described by the Diméglio modification of the Sauvegrain method. Records were reviewed from 2 children's hospitals from 1997 to 2008 to identify all patients younger than 18 years of age who had BBFA fractures treated with intramedullary nail fixation. Sixty-three patients were identified meeting inclusion and exclusion criteria. The stage of the olecranon apophysis was noted on the lateral radiograph at the time of the injury. Data were statistically analyzed to assess the olecranon stage at which the increased rate of delayed union becomes more prevalent using the receiver operating characteristic curve. Time to union, complications, and need for reoperation were recorded for each group. One thousand three hundred ninety-eight patient records were reviewed with 63 patients meeting the inclusion criteria. Using a receiver operating characteristic curve, a cutoff of olecranon stage > 3 (stages 4 to 7) was a significant predictor of the increased rate of delayed union time compared with olecranon stages 0 to 3 (P=0.004). Non-healing-related complication rates for each group were 2/28 (7.1%) for olecranon stages and 0 to 3 and 6/35 (17.1%) for olecranon stages 4 to 7. The rate of delayed union for BBFA fractures that have been treated with intramedullary nail fixation is increased in children with more mature olecranon apophyses as compared with those with younger olecranon stages. We propose the use of the stage of olecranon apophysis development when choosing the surgical approach and implant for when treating operative BBFA fractures in children. Level III-retrospective comparative study.

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3 citations in Scopus

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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Orthopedics
Pediatrics
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