Fractures of the proximal radius in children: management and results of 100 consecutive cases

Dietzel, Markus; Scherer, Simon; Esser, Michael; Kirschner, Hans‐Joachim; Fuchs, Jörg; Lieber, Justus

doi:10.1007/s00402-021-03917-w

Cited by 10 publications

(9 citation statements)

References 28 publications

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“…There was no statistically significant difference in complication rates between the TEN and K wire groups. At the same time, the radiographic and functional outcomes of the patients in this study were consistent with previously published studies [ 13 , 16 , 17 ]. When we analyzed the costs of the two groups, we found significant differences.…”

Section: Discussionsupporting

confidence: 91%

The Effects of Using K-Wire or Titanium Elastic Nails on Clinical and Radiological Outcomes in the Métaizeau Closed Reduction Technique

Aydın

Sürücü

2022

International Journal of Clinical Practice

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Aim. The purpose of this study was to compare the effects of using Kirschner-wire (K-wire) or titanium elastic nails (TEN) on the functional results of patients treated with the Métaizeau closed reduction technique, which is a popular treatment modality for pediatric radial neck fractures (PRNF). Methods. Patients who underwent the Métaizeau closed reduction technique for PRNF between May 2017 and May 2019 were assessed retrospectively. The Judet classification was used for the PRNF classification. The study consisted of patients who underwent the Métaizeau technique for Judet Type IV PRNFs and had at least 12 months of follow-up. Results. This study enrolled a total of 43 patients, 22 females and 21 males. Their mean age was 8.69 ± 2.3 at the time of surgery. The mean MEPS of patients undergoing K-wire surgery was 89.50, while the mean MEPS of patients undergoing TEN surgery was 92.83. There was no statistically significant difference between the two groups in terms of MEPS. When the complication rates of the two groups were evaluated, there was no statistically significant difference between them. The cost per patient for TEN was $40. The cost per patient for the K-wire was $1. Conclusion. The effect of K-wire or TEN used in the Métaizeau closed reduction technique on clinical outcomes is similar, and K-wire is more cost-effective.

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Section: Discussionsupporting

confidence: 91%

The Effects of Using K-Wire or Titanium Elastic Nails on Clinical and Radiological Outcomes in the Métaizeau Closed Reduction Technique

Aydın

Sürücü

2022

International Journal of Clinical Practice

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“…Twenty-six case series provided sufficient data regarding angulation at trauma, treatment details, and elbow ROM at follow-up [ 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 ]. The main characteristics of the included studies are listed in Table 3 .…”

Section: Resultsmentioning

confidence: 99%

Pediatric Radial Neck Fractures: A Systematic Review Regarding the Influence of Fracture Treatment on Elbow Function

et al. 2022

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Background: This review aims to identify what angulation may be accepted for the conservative treatment of pediatric radial neck fractures and how the range of motion (ROM) at follow-up is influenced by the type of fracture treatment. Patients and Methods: A PRISMA-guided systematic search was performed for studies that reported on fracture angulation, treatment details, and ROM on a minimum of five children with radial neck fractures that were followed for at least one year. Data on fracture classification, treatment, and ROM were analyzed. Results: In total, 52 studies (2420 children) were included. Sufficient patient data could be extracted from 26 publications (551 children), of which 352 children had at least one year of follow-up. ROM following the closed reduction (CR) of fractures with <30 degrees angulation was impaired in only one case. In fractures angulated over 60 degrees, K-wire fixation (Kw) resulted in a significantly better ROM than intramedullary fixation (CIMP; Kw 9.7% impaired vs. CIMP 32.6% impaired, p = 0.01). In more than 50% of cases that required open reduction (OR), a loss of motion occurred. Conclusions: CR is effective in fractures angulated up to 30 degrees. There may be an advantage of Kw compared to CIMP fixation in fractures angulated over 60 degrees. OR should only be attempted if CR and CRIF have failed.

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“…A higher degree of displacement is usually an indication for surgical treatment[ 3 , 23 , 24 ]. Studies comparing immobilization with percutaneous intervention and percutaneous with open treatment have shown that a conservative approach leads to better outcomes in terms of patient-reported outcome scores, range of motion and fewer complications[ 3 , 4 , 25 ]. However, these results may be confounded by the fact that more severely displaced fractures are often treated more aggressively.…”

Section: Treatment and Outcomementioning

confidence: 99%

“…Open reduction and internal fixation have been associated with a greater loss in range of motion and increased rates of osteonecrosis and synostosis compared to closed reduction techniques[ 3 , 25 , 36 ]. However, these results are controversial due to open reduction being more frequently used in fractures with a higher degree of displacement and more concomitant injuries.…”

Section: Treatment and Outcomementioning

confidence: 99%

“…Radio-ulnar synostosis is associated with open treatment of proximal radius fractures. Therefore, the incidence of synostosis is most effectively reduced by using minimally invasive techniques when possible[ 3 , 25 , 36 ]. Furthermore, it is the senior authors’ practice to remove bone dust using gel or water and avoid interfering with the radio-ulnar space.…”

Section: Complicationsmentioning

confidence: 99%

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Diagnosis, treatment and complications of radial head and neck fractures in the pediatric patient

Macken

Eygendaal

Bergen

2022

WJO

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Radial head and neck fractures represent up to 14% of all pediatric elbow fractures and can be a difficult challenge in the pediatric patient. In up to 39% of proximal radius fractures, there is a concomitant fracture, which can easily be overlooked on the initial standard radiographs. The treatment options for proximal radius fractures in children range from non-surgical treatment, such as immobilization alone and closed reduction followed by immobilization, to more invasive options, including closed reduction with percutaneous pinning and open reduction with internal fixation. The choice of treatment depends on the degree of angulation and displacement of the fracture and the age of the patient; an angulation of less than 30 degrees and translation of less than 50% is generally accepted, whereas a higher degree of displacement is considered an indication for surgical intervention. Fractures with limited displacement and non-surgical treatment generally result in superior outcomes in terms of patient-reported outcome measures, range of motion and complications compared to severely displaced fractures requiring surgical intervention. With proper management, good to excellent results are achieved in most cases, and long-term sequelae are rare. However, severe complications do occur, including radio-ulnar synostosis, osteonecrosis, rotational impairment, and premature physeal closure with a malformation of the radial head as a result, especially after more invasive procedures. Adequate follow-up is therefore warranted.

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Fractures of the proximal radius in children: management and results of 100 consecutive cases

Cited by 10 publications

References 28 publications

The Effects of Using K-Wire or Titanium Elastic Nails on Clinical and Radiological Outcomes in the Métaizeau Closed Reduction Technique

The Effects of Using K-Wire or Titanium Elastic Nails on Clinical and Radiological Outcomes in the Métaizeau Closed Reduction Technique

Pediatric Radial Neck Fractures: A Systematic Review Regarding the Influence of Fracture Treatment on Elbow Function

Diagnosis, treatment and complications of radial head and neck fractures in the pediatric patient

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