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Spontaneous Healing Of Hypertrophic Pseudoarthrosis Of Pediatric Mid Shaft Ulna With Elastic Stable Intramedullary Nailing In Situ: A Case Report

Bhattarai, A. 2024Other/Unknown

Bhattarai, A., Subedi, D., Bhandari, J., Homagain, S., Paudel, S., & Ghimire, J. (2024). Spontaneous healing of hypertrophic pseudoarthrosis of pediatric mid shaft ulna with elastic stable intramedullary nailing in situ: A case report. SAGE open medical case reports, 12, 2050313X241252747. https://doi.org/10.1177/2050313X241252747

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Abstract

Forearm fractures are the most common type of fractures in pediatric age. As children have excellent healing potential, fracture nonunion is a very uncommon complication. Elastic intramedullary nailing, a minimally invasive technique, is an excellent treatment modality for the unstable forearm shaft fractures in children, which can seldom lead to nonunion. Here, we present a case of hypertrophic pseudoarthrosis of mid shaft of ulna in a 13-year-old male, which healed spontaneously with elastic stable intramedullary nailing in situ.

Case Details

Disease Location

Ulna, radius

Personal Characteristics

13-year-old male

Clinical Characteristics

Complaint of pain and swelling over right forearm after he fell from a tree while playing. He sustained a closed fracture of the left radius and ulna. Closed reduction and intramedullary elastic nailing was successfully performed for the radius. An open reduction was needed for the ulna, and an elastic nail was placed in. Under regular follow-up, at 6 months, the radius united but the ulna developed a hypertrophic nonunion

Remission Characteristics

Ten months after the trauma, a bony consolidation without any axial malalignment could be documented

Treatment & Mechanisms

Proposed Remission Mechanisms

Open reduction and distraction of the fracture during nail inner- tion may have contributed to delayed bone healing

Clinical Treatment

Closed reduction and intramedullary elastic nailing, open reduction and intramedullary elastic nailing