Elastic stable intramedullary nailing versus Kirschner wire in the treatment of pediatric metaphyseal-diaphyseal junction fractures of the distal radius: a case-control study.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968565 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2474 (Electronic) Linking ISSN: 14712474 NLM ISO Abbreviation: BMC Musculoskelet Disord Subsets: MEDLINE

Original Publication: London : BioMed Central, [2000-

Fracture Fixation, Intramedullary*/methods ; Radius Fractures*/diagnostic imaging ; Radius Fractures*/surgery ; Radius Fractures*/etiology; Humans ; Child ; Bone Wires ; Radius ; Case-Control Studies ; Retrospective Studies ; Treatment Outcome ; Bone Nails

Background: Several methods have been used for the treatment of pediatric distal radius fractures, such as the elastic stable intramedullary nail (ESIN), Kirschner wire (K-wire), and plate, but there has been no consensus about the optimum method. The purpose of this study was to compare ESIN and K-wire techniques used in metaphyseal-diaphyseal junction (MDJ) fractures of the pediatric distal radius.
Methods: The data of patients who were treated at a children's hospital affiliated with Shandong University between August 2018 and January 2022 were analyzed retrospectively. The children were divided into the ESIN and K-wire groups. Clinical outcomes were measured by the Gartland and Werley scoring system. Variables were analyzed using a statistical approach between the two groups.
Results: The study included 26 patients, of whom 11 were treated with K-wire and 15 with ESIN. At the final follow-up, all of the fractures were healed. There were no differences in terms of age, sex, fracture location, or wrist function score. However, the ESIN was superior to K-wire in operative time, fluoroscopic exposure, and estimated blood loss (EBL).
Conclusions: K-wire and ESIN are both effective methods in the treatment of MDJ fractures of the pediatric distal radius. The use of the ESIN technique represents less EBL, fluoroscopy exposure, and operation time compared with K-wire. We recommend osteosynthesis by ESIN rather than K-wires in patients with MDJ fractures of the distal radius.
Level of Evidence: III, a case-control study.
(© 2023. The Author(s).)

Orthop Traumatol Surg Res. 2020 Feb;106(1):193-198. (PMID: 31843512)
Orthop Traumatol Surg Res. 2015 Sep;101(5):597-600. (PMID: 26198018)
J Pediatr Orthop. 1998 Jan-Feb;18(1):9-13. (PMID: 9449094)
BMC Musculoskelet Disord. 2020 Jun 9;21(1):365. (PMID: 32517675)
Orthopedics. 2013 Jun;36(6):783-8. (PMID: 23746016)
Injury. 2019 Feb;50(2):598-601. (PMID: 30635128)
J Am Acad Orthop Surg. 2010 Mar;18(3):180-9. (PMID: 20190108)
Int Surg. 2014 May-Jun;99(3):269-75. (PMID: 24833151)
Eur J Orthop Surg Traumatol. 2015 Apr;25(3):471-6. (PMID: 25331168)
Rev Chir Orthop Reparatrice Appar Mot. 1999 Dec;85(8):858-60. (PMID: 10637887)
J Child Orthop. 2011 Dec;5(6):459-64. (PMID: 23205147)
Acta Orthop Scand. 1987 Apr;58(2):121-3. (PMID: 3604624)
J Am Acad Orthop Surg. 2016 Nov;24(11):780-788. (PMID: 27755262)
Eur J Pediatr Surg. 2010 Nov;20(6):395-8. (PMID: 20938899)
J Pediatr Orthop B. 2017 Sep;26(5):412-416. (PMID: 27832017)
J Bone Joint Surg Am. 1951 Oct;33-A(4):895-907. (PMID: 14880544)
J Pediatr Orthop B. 2012 Mar;21(2):127-30. (PMID: 21934633)
Afr J Paediatr Surg. 2022 Jul-Sep;19(3):153-159. (PMID: 35775516)
Eur J Orthop Surg Traumatol. 2020 Oct;30(7):1243-1250. (PMID: 32405758)
Hand Clin. 2012 May;28(2):113-25. (PMID: 22554654)
J Child Orthop. 2021 Dec 01;15(6):532-539. (PMID: 34987662)
Orthop Traumatol Surg Res. 2011 May;97(3):330-4. (PMID: 21466983)
Eur J Orthop Surg Traumatol. 2019 Feb;29(2):413-420. (PMID: 30151639)
J Wrist Surg. 2019 Aug;8(4):305-311. (PMID: 31404224)
J Bone Joint Surg Am. 2008 Jun;90(6):1224-30. (PMID: 18519314)
Scand J Surg. 2021 Jun;110(2):276-280. (PMID: 33372581)
Biomed Res Int. 2018 Jul 12;2018:5930106. (PMID: 30112404)

Keywords: Children; Elastic stable intramedullary nail; Kirschner wire; Metaphyseal–diaphyseal junction; Radius fracture

Date Created: 20231201 Date Completed: 20231204 Latest Revision: 20231204

20240829

PMC10688113

10.1186/s12891-023-07055-9

38037015