Comparison of operating time, fluoroscopy exposure time, and functional and radiological results of two surgical methods for distal forearm fractures of both-bones in pediatric patients: Is it necessary to fix both bones?
Objective: The aim of this study was to compare the functional results of internal fixation of both forearm bones versus fixation of the radius alone in the treatment of distal both-bone forearm fractures in children. Methods: This study included a total of 34 children who were treated for distal forearm both-bone fracture. Patients were divided into two groups according to the technique used, which depended on the date of their surgery. Group 1 consisted of 18 children (14 males and four females; mean age: 10.3 years; age range: 7–16 years) who underwent both-bone fracture fixation using closed reduction and percutaneous pinning; Group 2 consisted of 16 children (12 males and four females; mean age: 10.1 years; age range: 6–15 years) who underwent only radius fracture fixation. The average follow-up was 65.6 months in Group 1 and 38.9 months in Group 2. Operating time, fluoroscopy exposure time, functional results (Mayo Wrist Score, visual analogue scale score, and range of motion), radiological results (time to union and malunion), and complications were recorded as outcome parameters. Results: The mean operating time was 35 min (range: 30-45 min) in Group 1 and 19 min (range: 10–25 min) in Group 2 (p
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1. Lieber JE, Schmid E, Schmittenbecher PP. Unstable diametaphyseal forearm fractures: Transepiphyseal intramedullary Kirschnerwire fixation as a treatment option in children. Eur J Pediatr Surg 2010; 20: 395-8. [CrossRef]2. Mostafa MF, El-Adl G, Enan A. Percutaneous Kirschner-wire fixation for displaced distal forearm fractures in children. Acta Orthop Belg 2009; 75: 459-66.
3. Mclauchlan GJ, Cowan B, Annan IH, Robb JE. Management of completely displaced metaphyseal fractures of the distal radius in children. J Bone and Joint Surg Br 2002; 84-B: 413-7. [CrossRef]
4. Miller BS, Taylor B, Widmann RF, Bae DS, Snyder BD, Waters PM. Cast immobilization versus percutaneous pin fixation of displaced distal radius fractures in children: A prospective, randomized study. J Pediatr Orthop 2005; 25: 490-4. [CrossRef]
5. Schmittenbecher PP. State-of-the-art treatment of forearm shaft fractures. Injury 2005; 36 (Suppl 1): A25-34. [CrossRef]
6. Colaris JW, Allema JH, Biter LU, et al. Re-displacement of stable distal both-bone forearm fractures in children: A randomised controlled multicentre trial. Injury 2013; 44: 498-503. [CrossRef]
7. Van Egmond PW, Schipper IB, van Luijt PA. Displaced distal forearm fractures in children with an indication for reduction under general anesthesia should be percutaneously fixated. Eur J Orthop Surg Traumatol 2012; 22: 201-7. [CrossRef]
8. Lee SC, Han SH, Rhee SY, Lee HJ, Hong CK. Percutaneous transphyseal pin fixation through the distal physis of the ulna in pediatric distal fractures of the forearm. J Orthop Trauma 2013; 27: 462-6. [CrossRef]
9. Jung HJ, Jung YB, Jang EC, et al. Transradioulnar single Kirschnerwire fixation versus conventional Kirschner-Wire fixation for unstable fractures of both of the distal forearm bones in children. J Pediatr Orthop 2007; 27: 867-72. [CrossRef]
10. Ali AM, Abdelaziz M, El-Lakanney MR. Intramedullary nailing for diaphyseal forearm fractures in children after failed conservative treatment. J Orthop Surg (Hong Kong) 2010; 18: 328-31. [CrossRef]
11. Alnaib M, Taranu R, Lakkol S, Aldlyami E, Alcelik I, Tulloch C. Radius-only intramedullary nailing for both-bones diaphyseal forearm fractures in children. Acta Orthop Belg 2011; 77: 458-63. [CrossRef]
12. Westacott D, Dickenson E, Smith N. Single-bone fixation of paediatric diaphyseal both-bone forearm fractures: A systematic review. Acta Orthop Belg 2012; 78: 425-30. [CrossRef]
13. Dietz JF, Bae DS, Reiff E, Zurakowski D, Waters PM. Single bone intramedullary fixation of the ulna in pediatric both bone forearm fractures: Analysis of short-term clinical and radiographic results. J Pediatr Orthop 2010; 30: 420-4. [CrossRef]
14. Salinsky JP, Parikh SN, Wall EJ. Shoehorn technique for reduction of distal radius fracture: A technical note. Am J Orthop (Belle Mead NJ) 2005; 34: 583-5.
15. Tageldin ME, Alrashid M, Khoriati A, Gadikoppula S, Atkinson HD. Periosteal nerve blocks for distal radius and ulna fracture manipulation - the technique and early results. J Orthop Surg Res 2015; 10: 134. [CrossRef]
16. Huang W, Zhang X, Zhu H, Wang X, Sun J, Shao X. A percutaneous reduction technique for irreducible and difficult variant of paediatric distal radius and ulna fractures. Injury 2016; 47: 1229-35. [CrossRef]
17. Webb GR, Galpin RD, Armstrong DG. Comparison of short and long arm plaster casts for displaced fractures in the distal third of the forearm in children. J Bone Joint Surg Am 2006; 88: 9-17. [CrossRef]
18. Flynn JM, Waters PM. Single-bone fixation of both- bone forearm fractures. J Pediatr Orthop 1996; 16: 655-9. [CrossRef]
19. Houshian S, Bajaj SK. Forearm fractures in children. Single bone fixation with elastic stable intramedullary nailing in 20 cases. Injury 2005; 36: 1421-6. [CrossRef]
20. Lee S, Nicol RO, Stott NS. Intramedullary fixation for pediatric unstable forearm fractures. Clin Orthop Relat Res 2002; 402: 245-50. [CrossRef]
21. Myers GJC, Gibbons PJ, Glithero PR. Nancy nailing of diaphyseal forearm fractures: Single bone fixation for fractures of both bones. J Bone Joint Surg 2004; 86-B: 581-4. [CrossRef]
22. Khandekar S, Tolessa E, Jones S. Displaced distal end radius fractures in children treated with Kirschner wires -A systematic review. Acta Orthop Belg 2016; 82: 681-9.
23. Lenoble E, Dumontier C, Goutallier D, Apoil A. Fracture of the distal radius. A prospective comparison between trans-styloid and Kapandji fixations. J Bone Joint Surg Br 1995; 77-B: 562-7. [CrossRef]
24. Saddiki R, Ohl X, Hemery X, Vitry F, Dehoux E, Harisboure A. Dorsally displaced distal radius fractures: Comparative study of Py’s and Kapandji’s techniques. Orthop Traumatol Surg Res 2012; 98: 61-7. [CrossRef]
25. Sharma S, Bowe D, Walters SJ, Flowers MJ. Dorsal cortical comminution as a predictor of redisplacement of distal radius fractures in children. Injury 2011; 42: 173-7. [CrossRef]
26. Handoll HHG, Vaghela MV, Madhok R. Percutaneous pinning for treating distal radial fractures in adults. Cochrane Database Syst Rev 2007; 18: CD006080. [CrossRef]
27. Du SH, Feng YZ, Huang YX, Guo XS, Xia DD. Comparison of pediatric forearm fracture fixation between single and double elastic stable intramedullary nailing. Am J Ther 2016; 23: e730-6. [CrossRef]
28. Jones DJ, Henley MB, Schemitsch EH, Tencer AF. A biomechanical comparison of two methods of fixation of fractures of the forearm. J Orthop Trauma 1995; 9: 198-206. [CrossRef]
29. Kirkos JM, Beslikas T, Kapras EA, Papavasiliou VA. Surgical treatment of unstable diaphyseal both-bone forearm fractures in children with single fixation of the radius. Injury 2000; 31: 591-6. [CrossRef]
30. Fuller DJ, McCullough CJ. Malunited fractures of the forearm in children. J Bone Joint Surg Br 1982; 64-B: 364-7. [CrossRef]
31. Carey PJ, Alburger PD, Betz RR, Clancy M, Stell HH. Both-bone forearm fractures in children. Orthopedics 1992; 15: 1015-9.
32. Madan S, Blakeway C. Radiation exposure to surgeon and patient in intramedullary nailing of the lower limb. Injury 2002; 33: 723- 7. [CrossRef]
33. Kraus R, Joeris A, Castellani C, Weinberg A, Slongo T, Schnettler R. Intraoperative radiation exposure in displaced supracondylar humeral fractures: A comparison of surgical methods. J Pediatr Orthop B 2007; 16: 44-7. [CrossRef]
34. Mastrangelo G, Fedeli U, Fadda E, Giovanazzi A, Scoizzato L, Saia B. Increased cancer risk among surgeons in an orthopaedic hospital. Occup Med (Lond) 2005; 55: 498-500. [CrossRef]
35. Ercole FF, Franco LMC, Macieira TGR, Wenceslau LCC, de Resende HIN, Chianca TCM. Risk of surgical site infection in patients undergoing orthopedic surgery. Rev Lat Am Enfermagem 2011; 19: 1362-8. [CrossRef]
36. Brin YS, Palmanovich E, Aliev E, et al. Closed reduction and internal fixation for intertrochanteric femoral fractures is safer and more efficient using two fluoroscopes simultaneously. Injury 2014; 45: 1071-5. [CrossRef]
37. Stahl S, Schwartz O. Complications of K-wire fixation of fractures and dislocations in the hand and wrist. Arch Orthop Trauma Surg 2001; 121: 527-30. [CrossRef]
38. Pritchett JW. Growth plate activity in the upper extremity. Clin Orthop Relat Res 1991; 268: 235-42.
- ISSN: 1017-995X
- Başlangıç: 2015
- Yayıncı: Türk Ortopedi ve Travmatoloji Derneği
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