Introduction: Pediatric both bone forearm fracture is a common injury in children. A multitude of current treatments are available, with Titanium Elastic Intramedullary Nail system becoming very popular. The advantages of this treatment are many; however, refracture of these nails in situ is a reported uncommon complication, and there is a paucity in the literature on the appropriate management in these cases.
Case report: An 8-year-old girl suffered from a left both bone forearm fracture after a fall from height, for which she was treated with the use of Titanium Elastic Intramedullary Nail system. Despite callus formation and fracture healing on X-rays, the nails were not removed at the intended time of 6 months due to the economic status of the country and the viral outbreak of COVID-19. Therefore, after 11 months of fixation, the patient presented again after a fall from height with the left both bone forearm refracture with the Titanium Elastic Intramedullary Nail system in situ. Intraoperative closed reduction was achieved with removal of the previous bent nails and refixation with new elastic nails. Follow-up of the patient 3 weeks later revealed satisfactory reduction with callus formation.
Conclusion: Pediatric both bone forearm refracture with Titanium Elastic Intramedullary Nail system in situ can be treated by gentle closed reduction and exchange nailing. This is not the first case to be managed with exchange nailing; however, it is one of the very few to have been treated as such and therefore these cases must be reported for further comparison with the different methods described in the literature to attain the optimal modality of treatment.
Keywords: Both bone forearm refracture; exchange nailing; titanium elastic intramedullary nail system in situ.
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