The Internal Diameter of the Radius and Ulna in Korean Children

Yong-Woon Shin; Jae-Kwang Yum; Hoon Jung; Jong Seok Oh

doi:10.4055/jkoa.2009.44.4.467

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Shin, Yum, Jung, and Oh: The Internal Diameter of the Radius and Ulna in Korean Children

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2009; 44(4): 467-472.

Published online: 21 July 2009

DOI: https://doi.org/10.4055/jkoa.2009.44.4.467

The Internal Diameter of the Radius and Ulna in Korean Children

Yong-Woon Shin, M.D., Jae-Kwang Yum, M.D., Hoon Jung, M.D., Jong Seok Oh, M.D.

Department of Orthopaedic Surgery, Sang-Gye Paik Hospital, Inje University College of Medicine, Seoul, Korea.

Correspondence to Jae-Kwang Yum, M.D. Department of Orthopaedic Surgery, Sang-Gye Paik Hospital, Inje University College of Medicine, 761-1 Sanggye 7-dong, Nowon-gu, Seoul 139-707, Korea. Tel: +82.2-950-1026, Fax: +82.2-934-6342, yumccf@hanmail.net

Received 11 December 2008 Accepted 27 June 2009

Abstract

Purpose

Flexible intramedullary nailing is a advanced method for treating forearm fractures with fewer complications. But sometimes these nails should not be used due to the narrower internal diameter of the forearm bones. We studied the inner diameter of the radius and ulna of children along with their age in relation to the width of the nail.

Materials and Methods

We reviewed the forearm AP radiographs of all the patients who visited our institute during a specific period, in which their age was between 6 and 19. We measured the inner diameters of the radius and ulna at their narrowest location, and we analyzed the diameter in relation to the patients' age groups, and we compared this data with the width for the nail.

Results

A total of 208 patients was included in this study. The inner diameter grew with their increasing age, and the younger the patients, the higher was the rate of inappropriate use of the nail. On linear regression analysis, the age plus or minus 1 SD for usage of the ready-made nail was 12.6 years-old for the male radius.

Conclusion

The nail was sometimes too thick for the diameter of the forearm bones of Korean children. It is correct for the surgeon to select whatever material to fix the fracture, but appropriate thickness of the nail should be selected thoughtfully in preoperative planning.

Keywords: Forearm bone fracture, Flexible intramedullary nail, Internal diameter measurement

Figures and Tables

Fig. 1

The lines show the narrowest points of internal diameter in the radius and ulna.

Fig. 2

The passable diameter for the bone is wider than the diameter of nail itself, with the tip bent for gliding against the endocortical surface.

Fig. 3

The graphs show distribution of the internal diameter of the radius in (A) mail and (B) female patients with the line of linear regression analysis. The line of limitation of passable thickness (3.5 mm) is crossed by the scatter plot line with -1 standard deviation from the average line, indicating appropriate age for using this device in about 84% of the population.

Table 1

Internal Diameters of the Bone Necessary to Pass the Nail according to the Nail Diameter (Provided by the Manufacturer: Synthes®)

Table 2

Demography of the Patients

Table 3

Average Internal Diameters of Forearm Bones of the Patients

^*ID, internal diameter.

Table 4

Internal Diameters of Forearm Bones Grouped by Age and Sex (ANOVA, by Tukey & Bonferroni)

Table 5

Equation of Linear Regression Analysis to Expect the Proper Age for Nail Passage

Table 6

The Rates of Patients with Bone Internal Diameter too Narrow to Pass the Nail

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