Terpylovskyy Y. Minimally invasive surgical treatment of diaphyseal forearm fractures in children

Plating and intramedullary nailing by K-wires, titanium elastic nails and rigid square-shaped nails are recognised fixation methods for both-bone midshaft forearm fractures in children. A biomechanical model was developed for the different types of osteosynthesis of diaphyseal forearm fractures in children (including fixation of both bones and single-bone fixation). Based on the biomechanical research results, literature analysis, own clinical experience, we proposed the hypothesis of rational surgical treatment for diaphyseal forearm fractures in children. Based on this hypothesis, we have proposed an algorithm of surgical treatment for diaphyseal forearm fractures in children. We conducted a retrospective analysis of surgical treatment in 152 children with diaphyseal fractures of the forearm, which included different types of osteosynthesis. Study results of the changes in subfascial pressure in the forearm during intramedullary osteosynthesis suggested that minimally invasive (closed) intramedullary osteosynthesis of diaphyseal forearm fractures in children is a safe method to use at any time after the injury.