Nonunion of a Pediatric Distal Radial Metaphyseal Fracture Following Open Reduction and Internal Fixation

Raet, Jan De; Kemnitz, Stefan; Verhaven, E.

doi:10.1007/s00068-007-6168-8

Cited by 4 publications

(3 citation statements)

References 14 publications

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“…This only amplifies the suspicion that this might be easily overlooked when functional impairment is not significant. Raet et al reports a case of distal radius non-union after plate fixation in a 9-year-old [12] where the radiological images appear similar to ours considering a pattern of recurrent displacement. Even in the 6-month follow-up image demonstrating nearly complete consolidation, one can still observe the tendency to angulate anteriorly.…”

Section: Discussionsupporting

confidence: 83%

Case Report of a Unique Intra-Operative Finding in a Pediatric Distal Radius Non-Union: Does This Shed Light on Other Non-Unions or Malunions in Children?

Negru,

Lazarescu,

Stanciulescu

et al. 2024

Children

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Non-unions are quite rare in closed fractures in children. Most distal radius fractures require orthopedic reduction and conservative treatment with very good radiological and clinical/functional results. In case of unsatisfactory reduction, surgical treatment is necessary to correct significant displacement. Surgical treatment consists of closed reduction and percutaneous fixation using K-wires. If closed reduction is not possible, open reduction and fixation is mandatory. Generally, fixation is obtained using K-wires, in most cases, even if open reduction is necessary, rarely locking plates, especially in adolescents. The present paper presents a case of non-union that eventually required open reduction and plating. During surgery, however, it became evident that the cause for non-union was the traumatic transposition of the long extensor radialis tendon, through the fracture site to the volar side of the distal forearm. The movement of the carpus translated to constant mobility in the fracture site, leading to non-union and a continuous tendency towards anterior angulation of the distal fragment. The tendon was reduced to its anatomical position, the fracture was reduced, and fixed using a locking plate, and union was achieved with no complications. Traumatic transpositions of tendons should be considered in pediatric non-unions, and restoring anatomy is essential.

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Section: Discussionsupporting

confidence: 83%

Case Report of a Unique Intra-Operative Finding in a Pediatric Distal Radius Non-Union: Does This Shed Light on Other Non-Unions or Malunions in Children?

Negru,

Lazarescu,

Stanciulescu

et al. 2024

Children

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“…Атрофия костей и множественные хирургические вмешательства создают серьезные проблемы для ревизионной операции. Известно, что для реконструкции конечности с серьезным костным дефектом и укорочением кости необходимо точное планирование [3,5,10,17]. Kwa et al описали несращение дистального отдела лучевой кости, хотя лечение проводилось исключительно при помощи костной пластики и наложения гипса [8].…”

Section: Discussionunclassified

“…Переломы предплечья -самые распространенные переломы у детей и подростков, чаще встречаются у мальчиков, чем у девочек [1][2][3]. Переломы предплечья, включая дистальную часть лучевой и локтевой кости, составляют до 36-45 % всех переломов у детей и подростков [4].…”

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Atrophic non-union with severe osteolysis of the radius in a healthy child: successful rescue surgery. Management with fibular allograft and autograft growth factors in a paediatric patient

Priano

D'Errico

Peretto³

et al. 2021

Pediatr Traum Orthop Reconstr Surg

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Background. Forearm fractures are the most frequent fractures in children and adolescents and they are more common in males than in females. In the last 20 years the increase of surgical indications have resulted in more complications, among them the non-unions, considered extremely rare and severe in children, have increased in incidence. We report a successful treatment of misdiagnosed forearm atrophic non-union with severe osteolysis using fibula allograft and autograft growth factors in a previously healthy 4-year-old child. Clinical case. A 4 year-old boy presented to our hospital with massive bone loss and a negative bone biopsy for Gorham-Stout Syndrome, he also showed reactive bone tissue with abnormal vascularity, necrotic osteocartilaginous fragments and giant mononucleated cells. Other lab tests did not show any modifications, so all the causes of paediatric osteolysis were ruled out. He had already undergone a few surgeries on that fracture and we performed others before achieving a good result, obtained with an autologous fibula graft with medullary growth factors stabilized with Kirschner wire. At the follow up 28 months later, the patient showed total consolidation of the initial area of non- union, no neurovascular deficit and no joint deficiency. Discussion. Non-union in paediatric patients is rare and therefore difficult to treat and diagnose. Since all of our tests ruled out the main causes of paediatric non-union, we managed the case with strategies usually applied to adult patients, carefully respecting the growth plates. Conclusion. Although this is a single-case report, it underlines the importance of early diagnosis, the difficulty to rule out some pediatric causes of bone loss and the complicances of a wrong diagnosis/treatment. It also shows that the use of allograft bone and autograft growth factors in a pediatric patient, who has undergone multiple surgeries, can lead to excellent results

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What is New in Pediatric Wrist Fractures?

Grenier

Samora

2019

Operative Techniques in Orthopaedics

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Nonunion of a Pediatric Distal Radial Metaphyseal Fracture Following Open Reduction and Internal Fixation

Cited by 4 publications

References 14 publications

Case Report of a Unique Intra-Operative Finding in a Pediatric Distal Radius Non-Union: Does This Shed Light on Other Non-Unions or Malunions in Children?

Case Report of a Unique Intra-Operative Finding in a Pediatric Distal Radius Non-Union: Does This Shed Light on Other Non-Unions or Malunions in Children?

Atrophic non-union with severe osteolysis of the radius in a healthy child: successful rescue surgery. Management with fibular allograft and autograft growth factors in a paediatric patient

What is New in Pediatric Wrist Fractures?

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