A retrograde comparative study comparing single versus double nancy nails for fixation of pediatric diaphyseal humeral shaft

Back ground: Humeral shaft fractures are a rare occurrence in pediatrics population and both conservative and operative treatments remain a valid option of management, recently there has been a trend towards minimally invasive ESIN fixation techniques for such fractures to facilitate early rehabilitation, whether a single ESIN is sufficient for provision of stability required for bone healing or the usage of double ESIN is essential will be determined by our study
Objective: The aim of the study is to delineate any differences in the use of single or double ESIN for operative fixation of humeral shaft fractures in children 3-14 years of age.
Patients and methods: 23 pediatric patients ranging from 3-14 years were included in the study, with 13 being treated with double ESIN and in 10 single ESIN was utilized for fixation with relative surgical indications being unacceptable alignment, open type 1 fractures and polytrauma.
Results: All patients were followed for up to 1 year, radiographic union was seen in double ESIN in mean 4 weeks and in single ESIN group in mean of 6 weeks, both groups achieved full union and did not suffer any significant complications. The operative time for double ESIN was found to be more than single ESIN group which was statistically different as well.
Conclusions: In comparison of double versus single ESIN, our group favours the single ESIN as there was no difference in terms of union rates or time to union between the two groups with single ESIN group having the advantage of being low cost and utilizing less operative time.