Plate Fixation for Unstable Displaced Distal Radius Fractures in Children

Egmond, Jeroen C van; Selles, Caroline A.; Cleffken, Berry; Roukema, Gert R.; Vlies, Kees H. van der; Schep, N.W.L.

doi:10.1055/s-0039-1688701

Cited by 14 publications

(9 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As an alternative to MWS, another tool to assess wrist function is PRWE. The score quantifies patient-rated wrist pain and disability partially along with hand function, and it has been used to evaluate children with distal radius fracture [65]. Nevertheless, as MWS, it is region-specific and does not consider hand dominance.…”

Section: Discussionmentioning

confidence: 99%

Review of pediatric functional outcomes measures used to evaluate surgical management in pediatric patients with an upper extremity fracture

Alberghina

Andreacchio

Pavone

et al. 2021

Journal of Pediatric Orthopaedics B

View full text Add to dashboard Cite

For two decades, many scores, questionnaires, and rating systems have been used to evaluate the functional outcome of children with an upper extremity fracture (UEF). However, only a few of these were created specifically for children, and many assess only elbow function. In the absence of any published review on this topic, we set out to identify and categorize different scores used to evaluate the clinical and functional outcomes of surgically treated pediatric UEFs. A literature search was performed, and 38 studies were identified. The scores used more often were the shortened version of the Disability of the Arm, Shoulder and Hand questionnaire and the Mayo Elbow Performance Score/Index. In a lower number of studies, authors used other scoring systems, including the Mayo Wrist Score, the Patient-Rated Wrist Evaluation, the Patient-Rated Elbow Evaluation, the Métaizeau functional scoring system, the Oxford Elbow Score, the Price and Flynn criteria, the Hardacre Functional Score, the Neer Shoulder Score, the Constant-Murley Shoulder Score, the Modified Orthopedic Trauma Association Score, the Medical Outcomes Study Short Form-36, and the Pediatric Outcomes Data Collection Instrument. Some specific pediatric scoring systems to evaluate the functional outcome of children with a UEF have been suggested, but a single tool that is valid and reliable for skeletally immature patients of all ages is not yet available. Further studies are needed to identify specific pediatric measurements to increase validity, responsiveness, sensitivity, and interpretability of upper limb functional outcome scores in common clinical practice.

show abstract

Section: Discussionmentioning

confidence: 99%

Review of pediatric functional outcomes measures used to evaluate surgical management in pediatric patients with an upper extremity fracture

Alberghina

Andreacchio

Pavone

et al. 2021

Journal of Pediatric Orthopaedics B

View full text Add to dashboard Cite

show abstract

“…While the overall complication rate associated with plating was low, plate removal was performed in 58% of patients, with 23% performed for plate-related complaints such as pain or stiffness. 50 Finally, plate fixation is associated with significantly higher costs than pinning. In adults, closed reduction and percutaneous pinning was associated with lower perioperative, 90-day and 1 year costs than open reduction and plate fixation.…”

Section: Plate Fixationmentioning

confidence: 99%

“…In one of very few studies of plating in pediatric patients, van Egmond and colleagues demonstrated good functional and radiographic outcomes with a low incidence of complications in their cohort of 26 patients with displaced, unstable distal radius fractures treated with volar plate fixation. While the overall complication rate associated with plating was low, plate removal was performed in 58% of patients, with 23% performed for plate-related complaints such as pain or stiffness 50…”

Section: Operative Managementmentioning

confidence: 99%

Management of Distal Radius Fractures in Adolescent Patients

Greig¹,

Silva

2021

Journal of Pediatric Orthopaedics

View full text Add to dashboard Cite

Background: While management recommendations for distal radius fractures in both young and skeletally mature patients have been generally well-established, controversy still exists regarding optimal management in adolescent patients approaching skeletal maturity. Thus, the goal of this review is to analyze relevant literature and provide expert recommendations regarding the management of distal radius fractures in this patient population. Methods: A PubMed search was performed to identify literature pertaining to distal radius fractures in adolescent patients, defined as 11 to 14 years in girls and 13 to 15 years in boys. Relevant articles were selected and summarized. Results: Distal radius fractures demonstrate significant potential for remodeling of angular deformity and bayonet apposition, even in patients older than 12 years of age. Rotational forearm range of motion and functional outcomes are acceptable with up to 15 degrees of residual angulation. Closed reduction and percutaneous pinning reduces fracture redisplacement but has a high associated complication rate. There is no literature comparing plate versus pin fixation of distal radius fractures in the pediatric population, but in adults plate fixation is associated with higher cost with no improvement in long-term functional outcomes. Conclusions: Remodeling can still be expected to occur in adolescent patients, and even with residual deformity functional outcomes after distal radius fractures are excellent. Up to 15 degrees of residual angulation can be accepted before considering operative management. Smooth pins should be considered over plates as first-line operative management for unstable fractures that fail nonoperative treatment.

show abstract

“…Several studies reported alternative surgical techniques to percutaneous pinning [ 6 – 10 ]. Favourable results with plate osteosynthesis or external fixation devices were reported, although these methods are more invasive or technically demanding [ 6 , 7 ]. Modified elastic intramedullary nailing techniques adapted to distal fractures have also been reported [ 8 – 12 ].…”

Section: Introductionmentioning

confidence: 99%

Bioresorbable implants vs. Kirschner-wires in the treatment of severely displaced distal paediatric radius and forearm fractures – a retrospective multicentre study

Varga

Józsa

Hanna

et al. 2022

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background Distal radius fractures are very common in paediatric patients. Severely displaced fractures may require surgical intervention. The gold standard surgical method is percutaneous K-wire osteosynthesis followed by immobilisation. Metal implants can be removed with a second intervention; however, these extra procedures can cause further complications. Several studies confirm the benefits of bioabsorbable implants for paediatric patients. The aim of this retrospective study was to compare the complication rates of displaced distal metaphyseal radius (AO 23r-M/3.1) and forearm (AO 23-M/3.1) fractures in children operated on with K-wires versus a novel technique with bioresorbable implants. Methods We retrospectively reviewed 94 patients in three paediatric trauma centres who underwent operations due to severely displaced distal forearm or metaphyseal radial fractures between January 2019 and January 2020. The mean age was 8.23 (ranging from 5–12). 30 patients (bioresorbable group, BR-group) were treated with biodegradable PLGA implants (Bioretec®, ActivaPin®), 40 patients with one or two stainless steel Kirschner-wires (K-wires, Sanatmetal®) which were buried under the skin (KW I-group) and 24 children with K-wires left outside the skin. (KWII. Group). We examined the number of minor and major complications as well as the need for repeated interventions. Follow-up was at least one and half year. Results There was no significant difference between the complication rates at the two KW groups (p = 0.241; Cramer’s V = 0.211), while the complication rate of the BR group was significantly lower. (p = 0.049; Cramer’s V = 0.293 and p = 0.002; Cramer’s V = 0.418 respectively). No later than half a year after the injury, no difference was observed between the functional outcomes of the patients in each group. One and a half years after the injury, no signs of growth disturbance were found in any of the children. No second surgical intervention was required in the BR group. Conclusions Surgeries with bioresorbable intramedullary implants may have fewer complications than K- wire osteosynthesis in the treatment of severely displaced distal forearm fractures. The benefits are most pronounced in the first six weeks after surgery, reducing the number of outpatient visits and increasing the child's sense of comfort. As no second intervention is required, this can lead to significant cost savings. After half a year, there is no difference in the outcomes between the different surgical treatment strategies.

show abstract

Plate Fixation for Unstable Displaced Distal Radius Fractures in Children

Cited by 14 publications

References 21 publications

Review of pediatric functional outcomes measures used to evaluate surgical management in pediatric patients with an upper extremity fracture

Review of pediatric functional outcomes measures used to evaluate surgical management in pediatric patients with an upper extremity fracture

Management of Distal Radius Fractures in Adolescent Patients

Bioresorbable implants vs. Kirschner-wires in the treatment of severely displaced distal paediatric radius and forearm fractures – a retrospective multicentre study

Contact Info

Product

Resources

About