Percutaneous Kirschner-wire pinning for severely displaced distal radial fractures in children. A report of 157 cases.
Distal radial fractures are common in children. Recent outcome studies have cast doubt on the success of treatment by closed reduction and application of plaster. The most important risk factor for poor outcome is translation of the fracture. If a distal radial fracture is displaced by more than half the diameter of the bone at the fracture site it should be classified as high risk. We performed percutaneous Kirschner-wire pinning on 157 such high-risk distal radial fractures in children under 16 years of age. The predicted early and late failure rate was reduced from 60% to 14% and only 1.5% of patients had significant limitation of forearm movement of more than 15 degrees in the final assessment at a mean of 31 months after operation. There were no cases of early physeal closure or deep infection.
Choi
K Y
KY
Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, New Territories.
Chan
W S
WS
Lam
T P
TP
Cheng
J C
JC
D000293:Adolescent; D001864:Bone Wires; D002648:Child; D004550:Elbow / Q000503:physiopathology; D005260:Female; D005542:Forearm / Q000503:physiopathology; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000150:complications; D007902:Length of Stay; D008297:Male; D009068:Movement / Q000502:physiology; D011859:Radiography; D011885:Radius Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014953:Wrist / Q000503:physiopathology