1.Comparison of effectiveness between two surgical methods for humeral lateral condyle fractures in children.
Hailong MA ; Qingjie WU ; Fang LIU ; Zhongtuo HUA ; Sicheng ZHANG
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(1):64-69
OBJECTIVE:
To compare the effectiveness of ultrasound-guided closed reduction with Kirschner wire fixation and open reduction with Kirschner wire fixation in the treatment of humeral lateral condyle fracture (HLCF) in children.
METHODS:
A clinical data of 53 children with HLCF admitted between May 2020 and April 2023 and met selective criteria was retrospectively analyzed. Of these, 25 cases were managed with closed reduction and Kirschner wire fixation under ultrasound guidance (closed group), while 28 cases underwent open reduction and Kirschner wire fixation (open group). There was no significant difference between the two groups in terms of gender, age, cause of injury, fracture side, fracture classification, and time from injury to operation ( P>0.05). The following variables were recorded and compared between the two groups: operation time, intraoperative fluoroscopy frequency, fracture healing time, incidence of complications, and the Flynn elbow function score at last follow-up.
RESULTS:
In the closed group, the fractures were successfully reduced under ultrasound guidance, with no nerve damage reported in either group. The operation time and intraoperative fluoroscopy frequency were significantly less in the closed group than in the open group ( P<0.05). One case of infection (Kirschner wire irritation) was observed in the closed group, while 3 cases in the open group (2 of Kirschner wire irritation and 1 of incision infection). However, the difference in the incidence of infection between the two groups was not significant ( P>0.05). All patients in both groups were followed up 6-18 months (mean, 10.2 months). X-ray examinations confirmed that fractures had healed in both groups, with no significant difference in healing time ( P>0.05). During follow-up, 5 cases of lateral humeral process formation were observed in the closed group, compared to 12 cases in the open group, although this difference was not significant ( P>0.05). At last follow-up, the excellent and good rate of elbow joint function was evaluated as 96.0% (24/25) in the closed group and 92.9% (26/28) in the open group according to the Flynn scoring criteria, with no significant difference between the two groups ( P>0.05). Both groups showed no occurrence of ossifying myositis or elbow internal/external rotation.
CONCLUSION
The effectiveness of ultrasound-guided closed reduction and Kirschner wire fixation in the treatment of HLCF in children is comparable to open reduction and Kirschner wire fixation, but the former can reduce operation time and intraoperative fluoroscopy frequency, and obtain lower the incidence of complications.
Humans
;
Humeral Fractures/diagnostic imaging*
;
Bone Wires
;
Male
;
Female
;
Child
;
Retrospective Studies
;
Fracture Fixation, Internal/instrumentation*
;
Treatment Outcome
;
Child, Preschool
;
Open Fracture Reduction/methods*
;
Fracture Healing
;
Elbow Joint/surgery*
;
Adolescent
;
Closed Fracture Reduction/methods*
;
Fluoroscopy
;
Operative Time
2.Application of elbow skin fold extension line in extreme elbow flexion in ulnar Kirschner wire insertion of extended supracondylar humeral fractures in children.
Xu LIU ; Wei WU ; Yuzhou SHAN ; Guanghui YANG ; Ming CHEN
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(1):70-74
OBJECTIVE:
To discuss the elbow skin fold extension line in Kirschner wire internal fixation of extended supracondylar humeral fractures in children.
METHODS:
The clinical data of 58 children with extended supracondylar fractures of the humerus who met the selection criteria between August 2021 and July 2024 were retrospectively analyzed. In 28 cases, needle placement of medial epicondyle of humerus was performed with the assistance of the elbow skin fold extension line (study group), and 30 cases were assisted by routine touch of the medial epicondyle of the humerus (control group). There was no significant difference in baseline data such as gender, age, side, cause of injury, Gartland type, Kirschner wire configuration, and time from injury to operation between the two groups ( P>0.05). The closed reduction rate, total operation time, time of medial humeral condyle pin placement, fluoroscopy times during medial pin placement, rate of one-time determination of medial entry point, ulnar nerve injury incidence, and fracture healing time were recorded and compared between the two groups. At the same time, the closed reduction rate of patients with the time from injury to operation ≤24 hours and >24 hours was compared. The elbow function was evaluated by Mayo elbow function score.
RESULTS:
The closed reduction rate of the study group was significantly higher than that of the control group ( P<0.05). Among all patients, the closed reduction rate of patients with the time from injury to operation ≤24 hours [73.3% (22/30)] was significantly higher than that of patients >24 hours [42.9% (12/28)] ( χ 2=5.545, P=0.019). The total operation time, medial needle placement time, and fluoroscopy times in the study group were significantly less than those in the control group, and the one-time determination rate of medial needle entry point in the study group was significantly higher than that in the control group ( P<0.05). There were 4 cases of ulnar nerve injury in the control group, and no ulnar nerve injury in the study group, but there was no significant difference in the incidence of ulnar nerve injury between the two groups ( P>0.05). All patients were followed up 6-12 months (mean, 8 months). There was no bone nonunion in both groups, and the fracture healing time of the study group was significantly shorter than that of the control group ( P<0.05). Volkmann ischemic contracture, heterotopic ossification, myositis ossificans, and premature epiphyseal closure were not observed after operation. No complications such as loosening or fracture of Kirschner wire occurred. At last follow-up, the Mayo elbow joint function score was used to evaluate function, and there was no significant difference between the two groups ( P>0.05).
CONCLUSION
In the treatment of extended supracondylar fractures of the humerus in children, the elbow skin fold extension line can help to quickly locate the medial epicondyle of the humerus, quickly insert Kirschner wire, and reduce the operation time and trauma.
Humans
;
Humeral Fractures/surgery*
;
Bone Wires
;
Male
;
Female
;
Fracture Fixation, Internal/instrumentation*
;
Retrospective Studies
;
Child
;
Elbow Joint/physiopathology*
;
Child, Preschool
;
Treatment Outcome
;
Fracture Healing
;
Ulnar Nerve/injuries*
;
Adolescent
;
Range of Motion, Articular
3.Effectiveness analysis of three internal fixation methods in treatment of avulsion fracture of tibial tubercle in adolescents.
Keyou DUAN ; Zhaodong WANG ; Yajun LIU ; Chen XU ; Zhonglian ZHU ; Jianzhong GUAN
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(1):75-82
OBJECTIVE:
To analyze the effectiveness of three internal fixation methods, namely hollow screw combined with Kirschner wire tension band, hollow screw combined with anchor nail, and modified 1/3 tubular steel plate, in the treatment of avulsion fracture of tibial tubercle (AFTT) in adolescents.
METHODS:
Between January 2018 and September 2023, 19 adolescent AFTT patients who met the selection criteria were admitted. According to different internal fixation methods, patients were divided into group A (8 cases, hollow screw combined with Kirschner wire tension band), group B (6 cases, hollow screw combined with anchor nail), and group C (5 cases, modified 1/3 tubular steel plate). There was no significant difference in the baseline data of age, gender, side, cause of injury, Ogden classification, and time from injury to operation among the three groups ( P>0.05). The range of motion (ROM), weight-bearing time, normal activity time of knee joint, and the hospital for special surgery (HSS) score at last follow-up were recorded and compared among the three groups. Recorded whether the fracture was displaced, whether the fracture line was blurred at 1 month after operation, whether there was epiphyseal dysplasia, and whether there was incision infection and other complications.
RESULTS:
There was no significant difference in hospital stay between the groups ( P>0.05). All patients were followed up 10-24 months, with an average of 14.3 months; there was no significant difference between the groups ( P>0.05). All the incisions healed well without soft tissue irritation or fracture nonunion, and no limb shortening deformity or epiphyseal dysplasia was found during follow-up. At 1 month after operation, the knee joint ROM and hospitalization expenses in group A were better than those in groups B and C, the fracture healing time, knee joint weight-bearing time, and normal activity time of knee joint were better than those in group C, and the hospitalization expenses in group C were better than those in group B, with significant differences ( P<0.05); there was no significant difference in the other indicators between the groups ( P>0.05). In group A, the fracture line was blurred 1 month postoperatively, the fracture ends were in close contact, and there was no fracture displacement; in groups B and C, the fracture line was clear in 2 cases, and 1 case in group C had slight fracture displacement; except for 1 case in group B, there was no fracture split in the other two groups. There was no significant difference in the incidences of blur of fracture line, fracture displacement, and intraoperative bone split between the groups at 1 month after operation ( P>0.05). At last follow-up, the HSS scores of knee joints in the three groups were excellent and good, and there was no significant difference between the groups ( P>0.05).
CONCLUSION
Hollow screw combined with Kirschner wire tension band technique is effective in treating adolescent AFTT, which has the advantages of stabilizing fracture, accelerating fracture healing and rehabilitation, early feasible knee joint functional exercise, and reducing hospitalization expenses.
Humans
;
Tibial Fractures/surgery*
;
Adolescent
;
Male
;
Fracture Fixation, Internal/instrumentation*
;
Female
;
Fractures, Avulsion/surgery*
;
Bone Wires
;
Bone Screws
;
Bone Plates
;
Treatment Outcome
;
Range of Motion, Articular
;
Bone Nails
;
Weight-Bearing
;
Fracture Healing
4.Impact of surgical timing on effectiveness of closed reduction and percutaneous Kirschner wire fixation for pediatric supracondylar humerus fractures.
Tianlong PAN ; Xianghua HOU ; Jingdong ZHANG
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(5):569-573
OBJECTIVE:
To compare the effectiveness of early versus delayed closed reduction and percutaneous Kirschner wire fixation in the treatment of pediatric supracondylar humerus fractures.
METHODS:
A retrospective analysis was conducted on 468 children with supracondylar humerus fractures, who were admitted between January 2020 and December 2023 and met the inclusion criteria. Among them, 187 children were treated during 12 hours after injury (early operation group) and 281 were treated after 12 hours (delayed operation group). There was no significant difference between the two groups ( P>0.05) in the gender, age, injury mechanism, fracture side and type, while there was significant difference in interval from injury to operation ( P<0.05). The operative outcomes, including the operation time, intraoperative blood loss, the length of hospital stay, fracture healing time, elbow function assessed by Flynn criteria at 3 months after operation, and complications, were compared.
RESULTS:
Compared to the delayed operation group, the early operation group demonstrated significantly shorter operation time and less intraoperative blood loss ( P<0.05). There was no significant difference in the length of hospital stay between the two groups ( P>0.05). All children were followed up 3-12 months. The follow-up time was (6.7±2.9) months in the early operation group and (6.9±2.8) months in the delayed operation group, showing no significant difference between the two groups ( P>0.05). There was no significant difference in the fracture healing time between the two groups ( P>0.05). At 3 months after operation, the early operation group exhibited superior Flynn elbow functional outcomes to the delayed operation group ( P<0.05). In the early operation group, there was 1 case of fracture non-union and 3 cases of cubital varus deformity after operation. In the delayed operation group, there was 1 case of nerve injury, 7 cases of fracture non-union, and 12 cases of cubital varus deformity after operation. There was significant difference in the incidence of complications between the two groups ( P<0.05). One case of the early operation group and 10 cases of the delayed operation group underwent secondary operation, showing no significant difference in the incidence of secondary operation between the two groups ( P>0.05).
CONCLUSION
For pediatric supracondylar humerus fractures, early closed reduction and percutaneous Kirschner wire fixation can reduce operation time, minimize intraoperative blood loss and postoperative complications, and improve the functional recovery compared to delayed operation.
Humans
;
Humeral Fractures/surgery*
;
Bone Wires
;
Retrospective Studies
;
Male
;
Female
;
Child
;
Fracture Fixation, Internal/instrumentation*
;
Child, Preschool
;
Treatment Outcome
;
Operative Time
;
Fracture Healing
;
Length of Stay
;
Closed Fracture Reduction/methods*
;
Blood Loss, Surgical
;
Time Factors
;
Time-to-Treatment
;
Postoperative Complications/epidemiology*
5.Effectiveness analysis of tension band-assisted fixation for volar marginal fractures of distal radius.
Abulimiti MIREADELI ; Wanming QU ; Tianbo ZHU ; Daoxin ZHANG ; Xiaokang ZHU ; Xinzhi LI ; Wenyao CHEN
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(6):662-667
OBJECTIVE:
To investigate the surgical technique and effectiveness of tension band-assisted plate fixation combined with external fixator for volar marginal fractures of the distal radius.
METHODS:
A retrospective analysis was performed on the clinical data of 12 patients with volar marginal fractures of the distal radius treated by Kirschner wire tension band-assisted anatomical plate fixation combined with external fixator between October 2018 and July 2023. The cohort included 9 males and 3 females, aged from 20 to 52 years (mean, 35.5 years). The injury causes included traffic accidents in 6 cases, falls from height in 3 cases, and fall in 3 cases. According to AO/Orthopaedic Trauma Association (AO/OTA), there were 1 case of type B2, 4 cases of type B3, 2 cases of type C1, 3 cases of type C2, and 2 cases of type C3. According to Fernandez classification, there were 2 cases of type Ⅲ, 5 cases of type Ⅳ, and 5 cases of type Ⅴ. Associated injuries included radiocarpal joint dislocation or subluxation in 7 cases and median nerve injury in 2 cases. The time from injury to operation was 2-7 days (mean, 3.2 days). Postoperatively, functional outcomes were evaluated using the modified Mayo wrist score and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Grip strength was measured as the ratio to the unaffected side, and wrist range of motion (ROM) including dorsiflexion, palmar flexion, ulnar deviation, and radial deviation was assessed.
RESULTS:
All procedures were successfully completed, with an operation time of 55-110 minutes (mean, 65 minutes). All patients were followed up 6-36 months (mean, 13.7 months). Surgical incisions healed by first intention, without complications such as vascular-nerve injury or infection. Bony union and articular congruency were attained in all patients, with a healing time of 3-5 months (mean, 3.8 months). During follow-up, 1 case of Kirschner wire migration occurred with no instances of infections, radiocarpal dislocations, internal fixation failures, or extensor pollicis longus tendon ruptures. At last follow-up, the modified Mayo wrist score ranged from 65 to 92 (mean, 80.8), the DASH score ranged from 7 to 15 (mean, 11.6), the grip strength was 65%-90% (mean, 78.2%) of the unaffected side; and wrist ROM was palmar flexion 60°-85° (mean, 77.4°), dorsiflexion 55°-80° (mean, 74.8°), radial deviation 10°-25° (mean, 18.8°), and ulnar deviation 15°-30° (mean, 24.5°).
CONCLUSION
Kirschner wire tension band-assisted anatomical plate fixation combined with external fixator for volar marginal fractures of the distal radius is a simple method with reliable fixation, which can achieve satisfactory effectiveness.
Humans
;
Male
;
Adult
;
Female
;
Radius Fractures/diagnostic imaging*
;
Retrospective Studies
;
Middle Aged
;
Bone Plates
;
Bone Wires
;
External Fixators
;
Young Adult
;
Fracture Fixation, Internal/instrumentation*
;
Treatment Outcome
;
Range of Motion, Articular
;
Hand Strength
;
Wrist Injuries/surgery*
6.Effectiveness of three-needle and two-cable structure in treatment of inferior patellar pole avulsion fractures.
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(6):686-691
OBJECTIVE:
To investigate the effectiveness of three-needle and two-cable structure in the treatment of inferior patellar pole avulsion fractures.
METHODS:
A clinical data of 62 patients with inferior patellar pole avulsion fractures who were admitted between January 2023 and December 2023 and met the selection criteria was retrospectively analyzed. Among them, the fractures were fixed with three-needle and two-cable structure in 32 patients (observation group) and traditional steel wire tension band in 30 cases (control group). There was no significant difference in the baseline data of age, gender, side of the affected limb, cause of injury, and disease duration between the two groups ( P>0.05). The operation time, fracture healing and healing time, patellar height (Insall-Salvati index), occurrence of complications, knee range of motion, and Böstman score at last follow-up were compared between the two groups.
RESULTS:
The operation time of the observation group was significantly shorter than that of the control group ( P<0.05). Patients in both groups were followed up 6-12 months (mean, 10.4 months). X-ray films re-examination showed that all fractures healed, and the fracture healing time was significantly shorter in observation group than in control group ( P<0.05); no significant difference was found in Insall-Salvati index between the two groups ( P>0.05). During follow-up, the complications occurred in 2 cases (6.25%) of observation group and in 9 cases (30.00%) of control group, and the difference in the incidences between the two groups was significant ( P<0.05). At last follow-up, the range of motion and Böstman score of the knee joint in observation group were significantly superior to control group ( P<0.05).
CONCLUSION
Compared with the traditional steel wire tension band fixation, the three-needle and two-cable structure fixation of the inferior patellar pole avulsion fractures is firm, which allows the knee joint to move early after operation and is conducive to the recovery of knee joint function.
Humans
;
Male
;
Patella/surgery*
;
Female
;
Fracture Fixation, Internal/instrumentation*
;
Retrospective Studies
;
Adult
;
Bone Wires
;
Fractures, Avulsion/surgery*
;
Middle Aged
;
Young Adult
;
Range of Motion, Articular
;
Treatment Outcome
;
Fracture Healing
;
Needles
;
Adolescent
;
Operative Time
7.Effectiveness of double joystick technique assisted treatment of Gartland type Ⅲ supracondylar fractures of the humerus in children.
Guangyao LI ; Feng HU ; He BAI ; Wei LIU ; Dandan HAN ; Quangui CHEN ; Shaolin TAN ; Ke SHA
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(9):1160-1164
OBJECTIVE:
To evaluate the effectiveness of double joystick technique assisted closed reduction and Kirschner wire internal fixation in the treatment of Gartland type Ⅲ supracondylar fractures of the humerus (SCFH) in children.
METHODS:
A retrospective study was conducted on 28 cases of Gartland type Ⅲ SCFH with complete data available, who underwent closed reduction and Kirschner wire internal fixation with the double joystick technique between August 2022 and July 2024. There were 23 boys and 5 girls, with an average age of 6.4 years (range, 1-12 years). All fractures resulted from falls and were classified as extension-type. X-ray film showed the radial displacement of the distal fragment in 15 cases and unlar displacement in 13 cases. The interval from injury to operation was 3-36 hours (mean, 19.5 hours). X-ray film re-examination was conducted to evaluate the fracture healing, and the Baumann angle of affected elbow joint and carrying angle of bilateral elbow joints were measured. Elbow joint function was evaluated using the range of motion (flexion and extension) and the Flynn criteria. The above indicators were compared between affected and healthy sides.
RESULTS:
All operation were successfully completed. The operation time ranged from 15 to 40 minutes (mean, 25.2 minutes). The length of hospital stay was 2-5 days (mean, 3.5 days). All patients were followed up 3-24 months (mean, 11.8 months). X-ray film confirmed fracture healing in all patients, with a mean healing time of 5.4 weeks (range, 4-6 weeks). At last follow-up, the Baumann angle of the affected elbow joint was (73.50±3.46)°, and the carrying angle and the range of motion in flexion and extension of the affected elbow joint were significantly less than the contralateral side (P<0.05). According to the Flynn criteria, the elbow joint function of the affected elbow was evaluated as excellent in 25 cases and good in 3 cases, with an excellent and good rate of 100%.
CONCLUSION
The double joystick technique is a safe and effective method which can facilitate the closed reduction and Kirschner wire internal fixation of Gartland type Ⅲ SCFH in children without increasing risk of complications.
Humans
;
Male
;
Female
;
Humeral Fractures/diagnostic imaging*
;
Fracture Fixation, Internal/instrumentation*
;
Child
;
Retrospective Studies
;
Bone Wires
;
Child, Preschool
;
Fracture Healing
;
Treatment Outcome
;
Infant
;
Elbow Joint/physiopathology*
;
Range of Motion, Articular
;
Closed Fracture Reduction/methods*
8.Clinical efficacy of open reduction and internal fixation with plates versus minimally invasive Kirschner wire fixation for osteoporotic Colles' fractures.
Jun-Wei ZHANG ; Jin-Yong HOU ; Zhao-Hui LI ; Zhen-Yuan MA ; Xiang GAO ; Hong-Zheng BI ; Ling-Ling CHEN ; Hai-Tao WANG ; Wei-Zhi NIE ; Yong-Zhong CHENG ; Xiao-Bing XI
China Journal of Orthopaedics and Traumatology 2025;38(1):18-24
OBJECTIVE:
To compare the short-term clinical efficacy and safety of closed reduction with Kirschner wire fixation versus open reduction with plate fixation for treating osteoporotic Colles' fractures in middle-aged and elderly patients.
METHODS:
Between January 2018 and January 2023, 119 patients with Colles fractures were retrospectively analyzed, including 39 males and 80 females, aged from 48 to 74 years old with an average of(60.58±6.71) years old. The time from injury to operation ranged 1 to 13 days with an average of (5.29±2.52) days. According to the surgical method, they were divided into Kirschner wire fixation group (Kirschner wire group) and plate internal fixation group (plate group). In Kirschner wire group, there were a total of 68 patients, comprising 21 males and 47 females. The average age was (61.15±6.24) years old, ranged from 49 to 74 years old. Among them, 41 cases involved the left side while 27 cases involved the right side. In the plate group, there were a total of 51 patients, including 18 males and 33 females. The average age was (59.78±5.71) years old ranged from 48 to 72 years old. Among them, there were 31 cases on the left side and 20 cases on the right side. The following parameters were recorded before and after the operation:operation time, intraoperative blood loss, hospitalization days, hospitalization expenses, postoperative complications, and radiographic parameters of distal radius (distal radius height, ulnar deviation angle, palmar tilt angle). The clinical efficacy was evaluated at 3 and 12 months after the operation using Gartland-Werley and disabilites of the arm shoulder and hand (DASH) scores.
RESULTS:
The patients in both groups were followed up for a duration from 12 to 19 months with an average of(13.32±2.02) months. The Kirschner wire group exhibited significantly shorter operation time compared to the plate group 27.91(13.00, 42.00) min vs 67.52(29.72, 105.32) min, Z=-8.74, P=0.00. Intraoperative blood loss was also significantly lower in the Kirschner wire group than in the plate group 3.24(1.08, 5.40) ml vs 21.91(17.38, 26.44) ml, Z=-9.31, P=0.00. Furthermore, patients in the Kirschner wire group had a shorter length of hospital stay compared to those in the plate group (8.38±2.63) days vs (11.40±2.78) days, t=-3.12, P=0.00. Additionally, hospitalization cost was significantly lower in the Kirschner wire group than in the plate group 10 111.29(6 738.98, 13 483.60) yuan vs 15 871.11(11 690.40, 20 051.82) yuan, Z=-5.62, P=0.00. The incidence of complications was 2 cases in the Kirschner wire group and 1 case in the plate group, with no statistically significant difference(P>0.05). At 3 months postoprative, the radial height of the Kirschner wire group was found to be significantly smaller than that of the plate group, with measurements of (11.45±1.69) mm and (12.11±1.78) mm respectively (t=-2.06, P=0.04). However, there were no statistically significant differences observed in ulnar deviation angle and palmar tilt angle between the two groups (P>0.05). The DASH score and Gartland-Werley score in the Kirschner group were significantly higher than those in the plate group at 3 months post-operation (19.10±9.89) vs (13.47±3.51), t=4.34, P=0.00;(11.15±3.61) vs (6.41±2.75), t=8.13, P=0.00). However, there was no significant difference between the two groups at 12 months post-operation (P>0.05).
CONCLUSION
Compared to plate internal fixation, closed reduction with Kirschner wire support fixation yields a slightly inferior recovery of radial height;however, there is no significant disparity in the functional score of the affected limb at 12 months post-operation. Nonetheless, this technique offers advantages such as shorter operation time, reduced intraoperative blood loss, decreased hospitalization duration, and lower cost.
Humans
;
Female
;
Male
;
Middle Aged
;
Aged
;
Fracture Fixation, Internal/instrumentation*
;
Bone Wires
;
Bone Plates
;
Retrospective Studies
;
Colles' Fracture/surgery*
;
Minimally Invasive Surgical Procedures/methods*
;
Open Fracture Reduction/methods*
;
Osteoporotic Fractures/surgery*
9.Short-term clinical efficacy of unilateral external fixator combined with percutaneous Kirschner wire fixation in the treatment of type C1 distal radius fractures in elderly patients.
Run-Bin SHEN ; Guo-Liang LI ; Xiao-Ping LIU ; Kang CHEN ; Guang-Pu HAN ; Jian-Yong ZHAO
China Journal of Orthopaedics and Traumatology 2025;38(1):25-30
OBJECTIVE:
To investigate the short-term clinical effect of closed reduction single arm external fixator combined with percutaneous needle fixation in the treatment of C1 distal radius fracture in elderly patients.
METHODS:
Between December 2022 and December 2023, a total of 60 elderly patients diagnosed with type C1 distal radius fractures were treated, comprising 9 males and 51 females. The age ranged from 65 to 84 years old, with an average of (72.69±8.14) years old. Among them, there were 18 cases on the left side and 42 cases on the right side. There were 55 cases of falling injury and 5 cases of traffic accident injury. According to the different surgical methods, the patients were divided into observation group and control group, with 30 cases in each group. The control group underwent manual reduction and unilateral external fixator fixation, consisting of 4 males and 26 females. The mean age was (72.54±8.67) years old. The body mass index (BMI) was (20.61±2.17) kg·m-2. There were 10 cases on the left side and 20 cases on the right side. Among them, there were 27 cases of falling injury and 3 cases of traffic accident injury. The observation group was treated with manual reduction and unilateral external fixator combined with percutaneous Kirschner wire fixation, including 5 males and 25 females. The mean age was (72.76±7.23) years old. BMI (20.82±2.03) kg·m-2. The left side was involved in 8 cases and the right side in 22 cases. There were 28 cases of falling injury and 2 cases of traffic accident injury. The changes in radial height, ulnar declination, palmar inclination angle parameters and patient-rated wrist evaluation (PRWE) were assessed on X-ray films before surgery, 2 days after surgery, and 12 weeks after surgery between the two groups.
RESULTS:
All surgical procedures were successfully completed in both groups without any significant complications. All patients were followed up for a duration from 12 to 20 weeks with an average of(14.50±2.78) weeks. The two groups exhibited significant differences in radial height, palmar inclination angle, and ulnar deviation angle at 2 days and 12 weeks post-operation (P<0.05). However, there was no statistically significant difference observed in radial height, palmar inclination, and ulnar deviation between the two groups at 2 days after the operation (P>0.05). There were significant differences in radial height, palmar inclination angle, and ulnar deviation between the two groups at 12 weeks after operation (P<0.05). At 2 days and 12 weeks after the operation, there were significant differences in PRWE scores of the two groups compared with preoperative scores(P<0.05). At 2 days after the operation, there was no significant difference in PRWE score between the two groups (P>0.05). The PRWE score showed a significant difference between the two groups at 12 weeks post-operation(P<0.05).
CONCLUSION
The combination of closed reduction and unilateral external fixator, along with percutaneous pin fixation provides move stable fixation for type C1 distal radius fractures. Gradual removal of external fixator further facilitatse the recovery of wrist joint function.
Humans
;
Male
;
Female
;
Radius Fractures/surgery*
;
External Fixators
;
Aged
;
Aged, 80 and over
;
Bone Wires
;
Fracture Fixation/instrumentation*
;
Wrist Fractures
10.Dorsally displaced distal radial double-column Die-punch fractures by dorsal approach external fixator combined with Kirschner wires.
Fu-de JIAO ; Jing-Wei ZHANG ; Li-Mei ZHU ; Lin AN ; Yun-Qiang ZHUANG ; Jian-Ming CHEN
China Journal of Orthopaedics and Traumatology 2025;38(1):87-91
OBJECTIVE:
Investigating the clinical efficacy of treating dorsally displaced distal radial double-column Die-punch fractures using a dorsal approach external fixator combined with Kirschner wires.
METHODS:
Retrospectively analyzed the clinical data of 15 patients with distal radial double-column Die-punch fractures treated with an external fixator combined with Kirschner wire between July 2020 and January 2023. There were 10 males and 5 females;6 cases on the left side and 9 on the right;age ranged from 22 to 76 years old. Recorded the preoperative and the final follow-up Cooney wrist function scores for the patients. The fracture healing time, and occurrence of complications were recorded.
RESULTS:
All 15 patients were followed up ranged from 12 to 16 months post-operation. All fractures achieved bony union, healing time ranging form 8 to 16 weeks. Not a single patient exhibited complications such as surgical site infection, fracture redislocation, or tendon injury. All individuals had their Kirschner wires and external fixation devices removed six weeks post-operatively and commenced rehabilitative therapy for wrist articulation. The Cooney wrist function scores at preoperative and ranged from 5 to 45 scores, at the latest follow-up ranged from 65 to 100 scores. At the final follow-up, the results were assessed as excellent in 10 patients, good in 4 patients, and fair in 1 patient.
CONCLUSION
The clinical efficacy of treating distal radial double-column Die-punch fractures using a dorsal approach external fixator combined with Kirschner wires is satisfactory.
Humans
;
Male
;
Female
;
Middle Aged
;
Adult
;
External Fixators
;
Bone Wires
;
Aged
;
Retrospective Studies
;
Radius Fractures/physiopathology*
;
Young Adult
;
Fracture Fixation/methods*

Result Analysis
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