Pre‐bent elastic stable intramedullary nail fixation for distal radial shaft fractures in children

Ge, Yihua; Wang, Zhigang; Cai, Haiqing; Yang, Jie; Xu, Yunlan; Li, Yuchan; Zhang, Yuchen; Chen, Bo-chang

doi:10.1111/j.1757-7861.2010.00092.x

Cited by 3 publications

(7 citation statements)

References 15 publications

(10 reference statements)

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“…Additionally, compliance with postoperative instructions may be relatively lower in adolescents, increasing the risk of unintentional injury to the affected limb. Considering these factors, the use of a cast after surgery provides additional external stability, complementing the internal fixation provided by the plate 7 . This approach aligns with the principle of pediatric fracture fixation, which emphasizes the use of internal fixation and strong external fixation to ensure optimal healing and minimize complications.…”

Section: Discussionmentioning

confidence: 96%

“…Each item was assigned a specific score. The scores were categorized into four levels, namely excellent (0-2), good (3)(4)(5)(6)(7)(8), fair (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), and poor (≥21).…”

Section: Gartland-werley Scorementioning

confidence: 99%

“…Pre‐bent ESIN fixation can preserve the physiological curvature of the bone, with additional advantages such as multi‐point support and high strength 8 . Earlier studies have shown the feasibility of this approach in the treatment of distal radial shaft fractures while retaining normal palmar inclination and ulnar deviation angles 7 . Emerging evidence also suggests that pre‐bent ESIN fixation could enhance the stability of radius reduction, improve fracture alignment, reduce the risk of secondary displacement of the distal fragment, and facilitate early rehabilitation of patients 9–11 .…”

Section: Introductionmentioning

confidence: 99%

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Clinical Outcomes of Minimally Invasive Fixation with Pre‐Bent Elastic Stable Intramedullary Nails for the Treatment of Distal Radius Metaphyseal Diaphysis Junction Fractures in Children

Yang,

Wang,

et al. 2023

Orthopaedic Surgery

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ObjectiveAlthough mini‐plate fixation is an attractive treatment option for distal radius metaphyseal diaphysis junction (DRMDJ) fractures in children, the benefits of minimally invasive fixation (MIF) with pre‐bent elastic stable intramedullary nails (MIF) remain underexplored. Therefore, this study aimed to evaluate the clinical efficacy of MIF administration in children with DRMDJ fractures.MethodsThis retrospective study enrolled 40 patients with DRMDJ fractures who underwent MIF or mini‐plate fixation from January 2016 to January 2021. Radiographic parameters, such as palmar inclination and ulnar deflection angle, were examined postoperatively to assess the anatomical reduction of the wrist joint. Clinical outcomes, including the range of wrist flexion and back extension, were examined to analyze the recovery of the wrist range of motion. Additionally, the Gartland–Werley scoring system was used to assess the recovery status of wrist function and healing condition. The student t‐test and χ2 test were used to compare differences among groups.ResultsAll included patients successfully underwent the operation and were followed up for 12–24 months. Patients in the MIF group had a smaller surgical incision length (0.49 ± 0.06 cm) compared to those in the mini‐plate fixation group (4.41 ± 0.73 cm) (t = 22.438, p = 0.000). Palmar inclination and ulnar deflection were within the normal range in patients of both groups, and the fractures were successfully anatomically reduced. Moreover, wrist flexion and back extension in the MIF group and mini‐plate group were (72.50° ± 0.64° vs. 70.18° ± 0.56°) and (59.55° ± 1.75° vs. 60.04° ± 1.37°), and differences were statistically significant (t = 2.708, p = 0.010 and t = 0.885, p = 0.382, respectively). Furthermore, MIF treatment resulted in a higher proportion of excellent Gartland–Werley scores (94.44%) than mini‐plate fixation (86.36%) (p = 0.390). In addition, one case in the mini‐plate fixation group experienced re‐fracture following the removal of the internal fixation, and the fracture healed after reduction and cast fixation. All patients achieved satisfactory bone healing without other complications.ConclusionCompared with mini‐plate fixation, MIF has the advantages of small incision length, superior range of motion of thr wrist joint, and better maintenance of the physiological radian, providing a promising approach for clinical and surgical treatment of DRMDJ fractures.

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Section: Discussionmentioning

confidence: 96%

Section: Gartland-werley Scorementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Outcomes of Minimally Invasive Fixation with Pre‐Bent Elastic Stable Intramedullary Nails for the Treatment of Distal Radius Metaphyseal Diaphysis Junction Fractures in Children

Yang,

Wang,

et al. 2023

Orthopaedic Surgery

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“…[ 13 – 15 ] Others suggest a specially prebent long, physis-sparing elastic nail to eliminate this problem. [ 16 – 18 ] All of these methods require postoperative plaster-cast immobilization. [ 2 , 6 , 16 – 18 ] Analyzing our own cases of pediatric distal radial fractures treated by percutaneous pinning between 2008 and 2014 (n = 184), we found a total complication rate of 16.84% retrospectively.…”

Section: Discussionmentioning

confidence: 99%

“…[ 16 – 18 ] All of these methods require postoperative plaster-cast immobilization. [ 2 , 6 , 16 – 18 ] Analyzing our own cases of pediatric distal radial fractures treated by percutaneous pinning between 2008 and 2014 (n = 184), we found a total complication rate of 16.84% retrospectively. Superficial infection occurred in 8 children, skin irritation in 14, migration of the wires in 5 cases, unacceptable redislocation in 2 cases, and growth disturbance and postoperative deformity in 2 cases.…”

Section: Discussionmentioning

confidence: 99%

Short, double elastic nailing of severely displaced distal pediatric radial fractures

Varga

Józsa²,

Fadgyas³

et al. 2017

Medicine

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Rationale:Short double elastic nailing is a minimal invasive, modified ESIN (elastic stable intramedullary nailing) technique for severely displaced distal radial fracture in children. The aim of this technical report is to introduce our new method and evaluate the final results of the procedure.Patient concerns:We reviewed retrospectively 24 patients who underwent short double elastic nailing due to distal radial fractures between November 2012 and December 2015. Indications for surgery included closed, severely displaced, unstable metaphyseal or diametaphyseal fractures of the radius.Intervention:The fractures were stabilized by 2 prebent short elastic titanium nails inserted from the distal side of the fracture. In cases of associated ulnar fracture, a classic anterograd ESIN nailing was also performed. Patients were mobilized immediately in a removable short splint which was removed after 1 to 2 weeks. There has been no additional splinting or casting.Outcomes:There were 17 males and 7 females with an average age of 9.8 years (range, 4–16 years). The right hand was involved in 16 cases and the left hand in 8 cases. The average follow-up was 17.8 months (range, 7–28 months). Of the 24 patients, 3 presented irritation of the skin, which resolved after removal of the radial nail. All the patients regained full range of motion without any complications.Lessons:Our technique is an effective, safe, and easily learnable procedure for unstable fractures of the distal third of the radius. It achieves good functional and radiological results, and allows early mobilization without the need of casting. Avoiding the physeal plates, we reduce the risk of iatrogenic postoperative deformity. Further prospective and biomechanical investigations are necessary to verify our experience.

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Results of Retrograde K-Wire Fixation in Diaphyseal Fractures of Forearm in Children

Shrestha

Karki

Lakhanpal

et al. 2017

J. Nepalgunj Med. College

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Background: Diaphyseal fractures of forearm is the third most common fracture in children. Majority of these fractures can be treated with close reduction and cast immobilization due to the growth potential of the immature skeletal. But in elder age group Intramedullary K wire fixation through retrograde approach is the most invasive and less complicated procedure to ensure the prevention of deformity and restore the functions. Aim: To evaluate the effectiveness of the treatment of diaphyseal fractures of forearm in children with intramedullary K wire fixation through retrograde approach and look for short term and immediate results. Methodology: This was a prospective observational hospital based study carried out in Nepalgunj Medical College Teaching Hospital from January 2012 to December 2013, in children between 5-15 years with K wires for diaphyseal fractures of forearm through retrograde approach which was followed up for 12 months. All patients underwent close reduction and intramedullary K wire fixation retrogradely. At 6, 12 and 48 weeks; range of motion and tenderness were looked for. Results: There were 32 patients in the study with average age of 10.41 years for male and 10.21 years for female. Average time for union was 7.3 weeks. There were no nonunions and malunions in follow ups. At 6 months all had full range of motion without any complications. Conclusion: Operative treatment with K wires through retrograde approach for diaphyseal fractures of forearm is an invasive procedure for less complications, patient's comfort and early range of motion.

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Pre‐bent elastic stable intramedullary nail fixation for distal radial shaft fractures in children

Abstract: Fixation with a pre-bent elastic stable intramedullary nail is an effective, safe and convenient method for treating distal radial shaft fractures in children.

Cited by 3 publications

References 15 publications

Clinical Outcomes of Minimally Invasive Fixation with Pre‐Bent Elastic Stable Intramedullary Nails for the Treatment of Distal Radius Metaphyseal Diaphysis Junction Fractures in Children

Clinical Outcomes of Minimally Invasive Fixation with Pre‐Bent Elastic Stable Intramedullary Nails for the Treatment of Distal Radius Metaphyseal Diaphysis Junction Fractures in Children

Short, double elastic nailing of severely displaced distal pediatric radial fractures

Results of Retrograde K-Wire Fixation in Diaphyseal Fractures of Forearm in Children

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