Limited open reduction and transepiphyseal intramedullary Kirschner wiring for irreducible fracture of the distal radius diaphysis-epiphysis junction in older children
10.3760/cma.j.cn115530-20231121-00208
- VernacularTitle:有限切开复位克氏针穿骺髓内固定大龄儿童难复性桡骨远端骨干-干骺端交界性骨折的疗效分析
- Author:
Liwei WU
1
;
Rufa WANG
Author Information
1. 南京医科大学附属儿童医院感染科，南京 210000
- Keywords:
Child;
Fracture fixation, intramedullary;
Radius fractures;
Forearm function
- From:
Chinese Journal of Orthopaedic Trauma
2024;26(5):416-420
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the feasibility and clinical efficacy of limited open reduction and transepiphyseal intramedullary kirschner wiring for treatment of irreducible fracture of the distal radius diaphysis-epiphysis junction in older children.Methods:A retrospective study was conducted to analyze the data of 17 children with fracture of the distal radius diaphysis-epiphysis junction who had been admitted to Department of Orthopedics, Children's Hospital of Nanjing Medical University from January 2018 to December 2019. All were male. Ten fractures were on the left side and 7 on the right side, all caused by indirect violent falls. The time from injury to operation was (3.1±0.8) d. After a limited incision, about 2 to 4 cm in length, was made with the fracture ends as the center, a single Kirschner wire was used for transepiphyseal and intramedullary fixation. Postoperative imaging results, incisions, forearm soft tissue, and complications were recorded. The forearm function was evaluated at 24 months after operation by the grading system proposed by Price et al.Results:All the 17 patients were followed up for (25.8±2.3) months. In all patients, operation time was 25 (20, 50) min, incision length (2.4±0.6) cm, postoperative angular deformity of the radius 0° (0°, 0°), and postoperative displacement of the radius (1.5±1.1) mm. Incisions healed well 2 weeks after operation with no vascular or neurological complications. Skin irritation of Kirschner wire appeared in 1 case. Fractures healed after 5.0 (4.0, 5.5) weeks. The forearm function evaluated by the Price grading at 24 months after operation was excellent in 15 cases and good in 2 cases.Conclusion:Limited open reduction and transepiphyseal intramedullary kirschner wiring is effective for treatment of irreducible fracture of the distal radius diaphysis-epiphysis junction in older children.
