Percutaneous leverage reduction with two Kirschner wires combined with the Métaizeau technique versus open reduction plus internal fixation with a single Kirschner-wire for treating Judet IV radial neck fractures in children

Du, Xinru; Yu, Lirong; Xiong, Zhigang; Gan, Chunfang; Zou, Jun; Wu, Xiaohong; Xiong, Bin; Wang, Baoli

doi:10.1177/0300060519825990

Cited by 12 publications

(14 citation statements)

References 17 publications

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“…Using US amid surgery is available to clearly present the displacement direction and radial neck fracture degree and guide fracture reduction through dynamic monitoring and precise positioning, which can signally reduce X-ray radiation among doctors and patients, shorten the time of operation, and improve reduction probability via minimally invasive treatment [ 1 , 12 , 27 ]. At the same time, combining with modified Métaizeau technique is available to avoid complications occurrences like a deep branch of radial nerve injury and epiphyseal plate injury [ 13 ]. After the internal fixation of fracture reduction, US-guided elbow arthrography is performed to improve the chances of success, and fracture quality reduction and fixation are evaluated intuitively and accurately under C-arm perspective machine [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…In young children, for the ossification center of the radius does not appear or has just appeared, it often does not develop in X-rays. In minimally invasive surgery, through a C-arm X-ray machine, it is difficult to judge the reduction quality [ 12 , 13 ], and doctors and patients need to receive larger X-ray radiation [ 7 , 12 ]. Reducing X-ray radiation and accurately judging fracture reduction quality to achieve minimally invasive treatment purposes and obtain valid clinical efficacy is worth research and discussion.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasonography-Guided Combination with Elbow Arthrography-Assisted Minimally Invasive Treatment of Radial Neck Fractures in Young Children

et al. 2022

Computational and Mathematical Methods in Medicine

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Background. A radius neck fracture in children is a common fracture that not only affects the growth and development of children but also has a certain impact on the function of children’s elbow joints. Objective. To probe into the application value of ultrasonography- (US-) guided combination with elbow arthrography in the minimally invasive treatment of radial neck fractures in young children, summarize its clinical effect and provide a minimally invasive, safe, effective, and reliable method for treating radial neck fractures in young children. Methods. Seventy-three patients with type III or IV radial neck fractures were treated from June 2013 to December 2020 and were divided into the Métaizeau group ( n = 31 , treatment group) and Kirschner wire ( k -wire) k -wire group ( n = 42 , control group). The Métaizeau group was given US-guided combination with elbow arthrography-assisted modified Métaizeau technique, the k -wire group received open reduction and internal fixation with k -wire and compared the surgical effect of the two groups. Results. In comparison with the k -wire group, time of operation, intraoperative bleeding volume, and hospital stay were signally junior to those in the Métaizeau group ( P < 0.05 ). After surgery, in comparison with the k -wire group, the number of degrees to contralateral flexion or forearm rotation was visually lower in the Métaizeau group ( P < 0.05 ), and postoperative complication incidence in the Métaizeau group was visually lower than that in k -wire group ( P < 0.05 ). Conclusion. In the minimally invasive treatment of radial neck fractures, US-guided combination with elbow arthrography in young children has better efficacy and high safety. It can be widely promoted and applied clinically.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ultrasonography-Guided Combination with Elbow Arthrography-Assisted Minimally Invasive Treatment of Radial Neck Fractures in Young Children

et al. 2022

Computational and Mathematical Methods in Medicine

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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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“…Judet Type 1 and 2 fractures can be treated nonoperatively with short-term immobilization. The majority of these individuals have a good prognosis and functional outcomes [ 6 ]. The treatment of Judet Type 3 radial neck fractures remains controversial in the literature [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Titanium elastic nails (TENs) are utilized in the Métaizeau technique for the joystick maneuver during fracture reduction and for fracture stability following reduction [ 5 ]. Many studies in the literature have focused on fracture reduction techniques in the Métaizeau closed reduction technique, as well as the comparison of different surgical treatments for PRNFs [ 6 , 7 ]. However, we were unable to find a study in the literature that investigated the implant features used in the Métaizeau closed reduction technique.…”

Section: Introductionmentioning

confidence: 99%

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

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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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Percutaneous leverage reduction with two Kirschner wires combined with the Métaizeau technique versus open reduction plus internal fixation with a single Kirschner-wire for treating Judet IV radial neck fractures in children

Cited by 12 publications

References 17 publications

Ultrasonography-Guided Combination with Elbow Arthrography-Assisted Minimally Invasive Treatment of Radial Neck Fractures in Young Children

Ultrasonography-Guided Combination with Elbow Arthrography-Assisted Minimally Invasive Treatment of Radial Neck Fractures in Young Children

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

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

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