Extraphyseal distal radius fracture in children: is the cast always needed? A retrospective analysis comparing Epibloc system and K-wire pinning

Passiatore, Marco; Vitis, Rocco De; Perna, Andrea; D’Orio, Marco; Cilli, V; Taccardo, Giuseppe

doi:10.1007/s00590-020-02698-z

Cited by 16 publications

(12 citation statements)

References 25 publications

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“…Distal radial fractures are common orthopedic injuries comprising 15% of all extremity fractures [ 1 ]. Though The K-wire pinning and minimally invasive system [ 2 ], external fixation [ 3 ] and dorsal plating [ 4 ] are considered as reasonable fixation options for the distal radial fractures, volar plating remains the most popular fixation techniques because of the safe and straightforward surgical approach, the low rate of complication, and the rapid return to function recovery [ 5 ]. Dorsal metaphyseal comminution (DMC) is the most common fracture pattern observed in 60% of the distal radius fractures [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

RETRACTED ARTICLE: Single volar locking plating for the intra- and extra-articular distal radius fractures with dorsal metaphyseal comminution

Gui

Cheng

et al. 2021

J Orthop Surg Res

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Background Volar locking plating remains a popular method for the surgical management of distal radius fractures. Dorsal metaphyseal comminution (DMC) is a common fracture pattern which weakens the stability during fracture fixation. In this study, we aimed to compare the radiographic and functional outcome of the intra- and extra-articular distal radius fractures with DMC following single volar locking plate fixation. Materials and methods Patients suffered from a distal radius fracture with DMC were reviewed in the clinical database of the authors’ institution between Jan 2016 and Jan 2020. The included patients were classified into the extra-articular (A3) group or the intra-articular (C2 and C3) group according to the AO/OTA system. The radiological parameters, wrist range of motion, and functional outcomes were evaluated following open reduction and volar locking plate fixation. Results A total of 130 patients were included in this study with a mean follow-up length of 17.2 months. Compared with the A3 fracture group, no significant fracture re-displacement or reduced wrist ROMs was observed in the C2 fractures after 12-month’s follow-up. However, significantly decreased volar tilt (P = 0.003) as well as the extension/flexion ROMs were observed in the C3 fractures comparing to the A3 fractures. Most of the patients achieved an excellent (n = 75) or good (n = 51) Gartland and Werley wrist score. Four patients with C3 fractures resulted in a fair functional outcome due to a significant loss of volar tilt during follow-up. Conclusions The single volar locking plate fixation provided sufficient stability for distal radius fractures with DMC, and resulted in similar radiological and functional outcomes in the intra-articular distal radius fractures with a simple articular component (C2 fractures) as those in the extra-articular fractures. Considering the intra-articular fractures with multifragmentary articular component (C3 fracture), despite of the subsequent loss of volar tilt, the majority of the patients achieved good to excellent wrist function following single volar locking plating. Trial registration This study has been registered on the ClinicalTrials.gov.

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Section: Introductionmentioning

confidence: 99%

RETRACTED ARTICLE: Single volar locking plating for the intra- and extra-articular distal radius fractures with dorsal metaphyseal comminution

Gui

Cheng

et al. 2021

J Orthop Surg Res

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“…The recent literature continues to prove it. The three-point intramedullary fixation system could be superior to the rigid interfragmentary fixation and it does not hinder the movement [ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…In surgical practice, ad hoc technological instruments (e.g., plates) often are preferred as opposed to K-wires because they are supposed to fix the fracture better. However, in adult upper limb fractures, a safe and effective fixation can be obtained with smooth wires and rods with very good functional outcome [ 18 – 20 ].…”

Section: Introductionmentioning

confidence: 99%

A Single Intramedullary K-Wire Is Sufficient for the Management of Nonthumb Metacarpal Shaft Fractures

Abulsoud

Elmarghany

Abd-Elghany

et al. 2021

Advances in Orthopedics

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Objective. This study aims to evaluate the outcome after the internal fixation of diaphyseal metacarpal fractures by a single intramedullary K-wire. Methods. In this prospective case series study, conducted from July 2017 to June 2019 in 23 adult patients with a single, unstable, diaphyseal metacarpal fracture, outcomes after internal surgical fixation using a single antegrade intramedullary K-wire were evaluated. The outcomes were evaluated by union rate, time to union, handgrip measurements at 6 and 12 months, and the modified Disabilities of the Arm, Shoulder, and Hand (DASH) score at 12 months. Results. The study population consisted of 17 males and 6 females, with a mean patient age of 28.4 ± 8.5 years (range, 16–45 years). The median time to final follow-up was 14 ± 1.8 months (range: 12–24 months). The mean duration of the union was 7.3 ± 1.6 weeks (range: 5–11 weeks), with a union rate of 95.7% (22 cases). The mean handgrip strength was 68% ± 12.8% of the strength of the uninjured hand after 6 months and 92.7% ± 6.9% after 12 months. The mean modified DASH score was 2.6 ± 0.26 after 12 months (range: 0–5.8). There were no cases of malrotation or infection. In conclusion, using a single 1.8–2.0 mm K-wire gives excellent functional outcomes and union rate without significant complications when used to treat an unstable metacarpal shaft fracture.

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“…Matsubara et al [ 15 ] were the first to show that if patients in the growing stage have to undergo surgery due to poor forearm function, satisfactory outcomes can be obtained by excessive lengthening of the ulna; this appears to be sufficient for improving the range of motion at the elbow and wrist joints. For patients with wrist deformity after ulnar lengthening, distal radius osteotomy combined with Epibloc™-system fixation is a good treatment option [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Modified osteotomy for treatment of forearm deformities (Masada IIb) in hereditary multiple osteochondromas: a retrospective review

Yan

Guo

2021

BMC Musculoskelet Disord

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Purpose Approximately 30% of patients with hereditary multiple osteochondromas (HMO) have forearm deformity and dysfunction. The aim of this retrospective study was to review our experience with the surgical treatment of children with HMO and Masada IIb forearm deformities. Methods Data of eight children treated for HMO Masada IIb forearm deformity at our hospital between 2015 and 2019 were collected from the hospital records and retrospectively reviewed. All patients underwent ulnar lengthening by distraction osteogenesis using either the Orthofix or Ilizarov external fixator. Range of movements at the elbow and wrist joints, and forearm supination/pronation, before and after the operation were recorded. Radiographs were evaluated by the Fogel method, and wrist joint function by the Krimmer method. Results Follow-up radiographs showed significant improvement in relative ulnar shortening after treatment (pre-operative 9.23 ± 5.21 mm; post-operative 0.33 ± 4.13 mm). Changes in radial articular angle (pre-operative 33.55° ± 3.88° to 32.78° ± 6.57°) and carpal slip (pre-operative 45.00% ± 19.09%; post-operative 43.13% ± 16.68%) were not significant. Elbow flexion and extension, wrist flexion and extension, ulnar and radial deviation at wrist, and forearm rotation were significantly improved after surgery. Wrist function was graded as excellent in seven patients and as good in one patient. One patient treated with the Ilizarov external fixator had poor radial head reduction. Conclusion Ulnar lengthening with distraction osteogenesis is an effective treatment for HMO Masada IIb deformities. The optimum site for ulnar osteotomy appears to be at the proximal one-third to one-fourth of the ulna.

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Extraphyseal distal radius fracture in children: is the cast always needed? A retrospective analysis comparing Epibloc system and K-wire pinning

Cited by 16 publications

References 25 publications

RETRACTED ARTICLE: Single volar locking plating for the intra- and extra-articular distal radius fractures with dorsal metaphyseal comminution

RETRACTED ARTICLE: Single volar locking plating for the intra- and extra-articular distal radius fractures with dorsal metaphyseal comminution

A Single Intramedullary K-Wire Is Sufficient for the Management of Nonthumb Metacarpal Shaft Fractures

Modified osteotomy for treatment of forearm deformities (Masada IIb) in hereditary multiple osteochondromas: a retrospective review

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