Treatment of paediatric unstable displaced distal radius fractures using Kapandji technique: a case series

Valisena, Silvia; Gonzalez, Jorge Gabriel; Voumard, Natalia; Hamitaga, Flurim; Ciritsis, Bernhard; Sagaon, Mario Mendoza; Rosa, Vincenzo De

doi:10.1007/s00590-018-2297-5

Cited by 11 publications

(14 citation statements)

References 24 publications

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“…However, cortical penetration is quite challenging in this technique. Kapandji technique has been reported in the treatment of DDRF in children [23], but it is not the mainstream choice and not adopted in our institute. In clinical practice, multiple KWs placement might be required for an adequate reduction and stable construct; however, it might increase the risk of iatrogenic injury [24].…”

Section: Discussionmentioning

confidence: 98%

Fixation of delayed distal radial fracture involving metaphyseal diaphyseal junction in adolescents: a comparative study of crossed Kirschner-wiring and non-bridging external fixator

Rai

Tang

et al. 2020

BMC Musculoskelet Disord

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Background: Conservative treatment remains the preferred choice for distal radius fracture in children. However, loss of reduction is problematic, especially in an older child. Crossed Kirschner-wires is widely used to treat distal radius fracture in adolescents. This study aimed to compare the application of crossed Kirschner-wiring (KW) and non-bridging external fixator (EF) for the treatment of delayed distal radial fracture involving metaphyseal diaphyseal junction (MDJ) in adolescents. Methods: Between January 2012 to January 2017, 146 (male = 101, female = 45) patients in EF group and 117 (male = 76, female = 41) in KW group, were reviewed retrospectively. Preoperative data were collected from the hospital database, and postoperative clinical outcomes data were collected during the follow-up visits. We used SPSS for data analysis. Results: There existed no significant difference between EF and KW regarding sex, body weight, fracture side, duration from injury to surgery. The duration of surgery was significantly shorter in EF (30.5 ± 6.1 min) than the KW group (44.6 ± 9.4 min), P < 0.001. The number of intraoperative X-ray images was significantly lower in EF (6.5 ± 1.1) than KW (11.8 ± 2.3), P < 0.001. The incidence of tendon irritation is significantly higher in the KW (19.7%) than the EF group (0%), P < 0.001. The residual angulation on the AP view was higher in KW (3.8 ± 2.3, degrees) than the EF group (2.5 ± 1.6, degrees), P < 0.001. The volar tilting is better in EF (6.6 ± 1.1, degrees) than the KW group (1.0 ± 1.5, degrees), P < 0.001. However, the functional outcomes of the wrist showed no significant difference between EF and KW group, P = 0.086. Conclusion: The EF was superior to KW in the treatment of radial MDJ fractures in adolescents. The EF displayed shorter duration of surgery, less tendon irritation, and better radiographic outcomes than the KW. However, the cost-effect analysis remains to be investigated, because the EF is more expensive than KW.

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Section: Discussionmentioning

confidence: 98%

Fixation of delayed distal radial fracture involving metaphyseal diaphyseal junction in adolescents: a comparative study of crossed Kirschner-wiring and non-bridging external fixator

Rai

Tang

et al. 2020

BMC Musculoskelet Disord

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“…Nietosvaara et al (2005) recommended percutaneous K-wire pinning in cases where the initial displacement of fractures exceeded 50% (width of shaft), cases where primary reduction is not fully anatomic and in children with less than 1 year of growth left. Valisena et al (2019) used a single dorsal intrafocal K-wire (2 or 2.5 mm) to reduce and stabilize the fracture combined with an above-elbow cast in six patients, one of whom had a distal radius growth arrest requiring subsequent distal ulna epiphysiodesis. In our study, all children had radiological union with good functional outcome, and none had growth disturbances or physeal bar formation on MRI imaging.…”

Section: Discussionmentioning

confidence: 99%

Salter-Harris II distal radial fractures treated with the intrafocal K-wire technique: a retrospective study of 20 cases

Jerome¹

2020

J Hand Surg Eur Vol

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We retrospectively reviewed 20 children with Salter-Harris II fractures of the distal radius treated with intrafocal pinning according to Kapandji. Unlike conventional crossed K-wire pinning, this method avoids crossing the physis with the pins and thus minimizes the risk of physeal damage. None of the children had fracture re-displacement, angulation or growth deformities. The age, sex, side of injury, fracture displacement or angulation, treatment delay or immobilization period had any significant impact on the functional outcome. At a mean follow-up of 49 months (range 47–60), plain radiographs and MRI showed no growth arrests or physeal bars or bridges. Grip strength, wrist motion and patient-reported outcomes were almost normal with no or minimal pain at the injury site. We conclude that intrafocal K-wire pinning is simple, safe and affordable. We cannot provide data on what is acceptable fracture displacement for different age groups to allow for acceptable final remodelling of any malalignment. Level of evidence: IV

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“…A K-wire is inserted between fracture fragments to lever the fracture to achieve reduction while a different K-wire or two are placed to secure fixation; alternatively, reduction may be performed with a Freer elevator in this way. 52,53 (Figure 12)…”

Section: Proximal Radiusmentioning

confidence: 99%

The Pin: An Orthopaedic Transformation

Lindsay¹,

Holmes²,

Owen³

et al. 2022

Journal of the Pediatric Orthopaedic Society of North America

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The stainless-steel pin has become an important part of operative orthopaedics over the last several decades. It is used in all subspecialties as tool to localize a lesion or to effectuate reduction, as a conduit for implant placement (screw or blade plate), as a guide for making an osteotomy, and as an implant that can stabilize bone whether it is placed in an open or percutaneous manner. While simple and ubiquitous to the craft of orthopaedics, it has revolutionized the care of children with orthopaedic conditions. This review highlights the history and the applications of the simple pin that can assist in obtaining good results in common problems.

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Treatment of paediatric unstable displaced distal radius fractures using Kapandji technique: a case series

Abstract: Kapandji pinning is a reliable technique in paediatric patients with unstable displaced distal radius fractures. It shows a lower complication rate compared to other techniques. For these reasons, we suggest implementing its use in clinical practice.

Cited by 11 publications

References 24 publications

Fixation of delayed distal radial fracture involving metaphyseal diaphyseal junction in adolescents: a comparative study of crossed Kirschner-wiring and non-bridging external fixator

Fixation of delayed distal radial fracture involving metaphyseal diaphyseal junction in adolescents: a comparative study of crossed Kirschner-wiring and non-bridging external fixator

Salter-Harris II distal radial fractures treated with the intrafocal K-wire technique: a retrospective study of 20 cases

The Pin: An Orthopaedic Transformation

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