Intramedullary wire fixation for unstable forearm fractures in children

Altay, Murat; Aktekin, Cem Nuri; Özkurt, Bülent; Birinci, Baris; Öztürk, Akif Muhtar; Tabak, Abdullah Yalçın

doi:10.1016/j.injury.2006.06.017

Cited by 39 publications

(29 citation statements)

References 21 publications

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“…Over time the treatment of both-bone forearm shaft fractures in children has become increasingly surgical in nature1,17–19,29,30. However, before closed reduction and casting should be supplanted as the preferred method of treatment for these injuries, clinicians must understand the circumstances in which surgery may be more advantageous29.…”

Section: Discussionmentioning

confidence: 99%

“…Fracture re-manipulation with closed reduction and casting is another viable option if initial reduction is insufficient. Operative techniques, including ESIN, have been shown to effectively prevent re-angulation17–21. However, surgery carries its own risk of complications, and it is wise to remember Sarmiento’s advice that closed fracture treatment must not be abandoned for newer, less proven, surgical techniques, and that surgical intervention does not always restore a normal range of forearm motion7,39.…”

Section: Discussionmentioning

confidence: 99%

“…Elastic stable intramedullary nailing (ESIN) is an effective treatment for forearm shaft fractures in children that has abundant support in the literature17–21. This technique is best applied early in the post-fracture time period as it becomes progressively difficult to perform as callus formation occurs22.…”

Section: Introductionmentioning

confidence: 99%

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Nonoperative Treatment of Both-bone Forearm Shaft Fractures in Children

Bowman

Mehlman

Lindsell

et al. 2011

Journal of Pediatric Orthopaedics

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Nonoperative Treatment of Both-bone Forearm Shaft Fractures in Children

Bowman

Mehlman

Lindsell

et al. 2011

Journal of Pediatric Orthopaedics

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“…Delayed rupture of the EPL is rare after distal radial fractures but seems to be increasing following ESIN for diaphyseal fractures of the radius [3]. ESIN is generally considered a minimally invasive procedure [21], with low rates of complications [1, 2, 4, 14]. A recent large study of complications and outcomes of diaphyseal forearm fractures reported good to excellent outcomes in 91 % of fractures, with a 17 % rate of grade 2–4 complications according to a new classification system [22].…”

Section: Discussionmentioning

confidence: 99%

Rupture of the extensor pollicis longus tendon following dorsal entry flexible nailing of radial shaft fractures in children

Brooker

Harris

Donnan

et al. 2014

Journal of Children's Orthopaedics

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IntroductionDiaphyseal forearm fractures are common in children and adolescents. Intramedullary fixation with flexible nails has a high success rate. Complications related to the insertion of the radial nail include injury to the superficial branch of the radial nerve and rupture of the extensor pollicis longus (EPL) tendon.Materials and MethodsWe report a series of nine patients who sustained an EPL injury related to the insertion of an elastic intramedullary nail into the radius.ResultsAll nine patients underwent operative management, consisting of either EPL release, EPL direct repair, or tendon transfer (using extensor indicis proprius). In all cases, the nail entry site was directly related to the location of EPL. In many of the cases the EPL dysfunction occurred early on but it’s recognition was often delayed.ConclusionBased on our findings, we recommend the use of a radial entry point. For surgeons who prefer the dorsal entry point, we recommend that they use an incision which allows visualisation of the extensor tendons and that any post-operative EPL dysfunction is addressed promptly.

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“…The advantages, including minimal invasion, greater stability, and less complication, have been described in many reports. [10][11][12][13][14] However, there is no report about its application in the distal radius fracture. The reason is mainly that the elasticity of the intramedullary nail will push the proximal end of the fracture to the opposite side and result in angular deformity and inaccurate reduction.…”

mentioning

confidence: 99%

Prebending of a Titanium Elastic Intramedullary Nail in the Treatment of Distal Radius Fractures in Children

Cai

Wang

Cai

2014

International Surgery

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The aims of this study were to introduce a method to treat distal radius diaphyseal metaphyseal junction fractures by prebending an elastic intramedullary nail and to evaluate the factors influencing fracture apposition. Fifty-two consecutive patients (4 to 15 years old) with a distal radius diaphyseal metaphyseal junction fracture were included. The nail was inserted and advanced into the proximal radial fragment as normal. After bending the nail distally about 908 at the site predetermined to lie at the distal segment, the elastic intramedullary nail was advanced until the prebent part completely entered the marrow cavity. The fracture angular deformity was fully corrected in anterior-posterior and lateral views. The apposition rate was 90% to 100% in lateral view, .50% in anterior-posterior view. The operation time was 16.73 6 6.253 minutes. The average time of fracture healing was 5 months (range, 4-7 months). During 12 to 19 months of follow-up, firm fracture healing and good remodeling were observed, and there was no impaired forearm rotation function or secondary fracture. Our study showed the treatment of distal radius diaphyseal metaphyseal junction fractures by prebent intramedullary nail could make up for the deficiency of Kirschner wires and steel plates and keep the fracture stable. Fracture type and the anatomical features of the distal radius were associated with fracture apposition.

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Intramedullary wire fixation for unstable forearm fractures in children

Cited by 39 publications

References 21 publications

Nonoperative Treatment of Both-bone Forearm Shaft Fractures in Children

Nonoperative Treatment of Both-bone Forearm Shaft Fractures in Children

Rupture of the extensor pollicis longus tendon following dorsal entry flexible nailing of radial shaft fractures in children

Prebending of a Titanium Elastic Intramedullary Nail in the Treatment of Distal Radius Fractures in Children

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