Percutaneous Kirschner Wire Poking Reduction and Antegrade Elastic Stable Intramedullary Nail for the Treatment of Distal Adius Fractures in Children
Objective To investigate the clinical efficacy of percutaneous Kirschner wire poking reduction and anterograde elastic stable intramedullary nail(ESIN)treatment for radial diaphysis and distal radius diaphyseal metaphyseal junction(DRDMJ)fractures in children through a proximal radius approach.Methods A retrospective analysis was conducted on the clinical data of children with distal radius metaphyseal and DRDMJ fractures treated with anterograde ESIN in the Department of Pediatric Orthopedics of the First Affiliated Hospital of Wannan Medical College from November 2021 to November 2022.The fracture healing status,forearm rotation activity,and elbow joint flexion and extension activity were regularly followed up.The Gartland Werley wrist joint function score was used to evaluate wrist joint function.Simultaneously,during the follow-up before and after removing the ESIN,the rotational activity range of the injured forearm was measured and compared with the uninjured side.Results All 21 patients successfully completed the surgery and were followed up for 6-12 months,with an average of 9.5 months.After 8-16 weeks of surgery,all fractures achieved clinical healing.No radial nerve injury or skin irritation symptoms occurred in all postoperative patients.In terms of imaging,there were no cases of fracture displacement,internal fixation detachment,or bone nonunion.At the last follow-up,there was no loss in pronation and supination activity range of the injured forearm compared to the uninjured side,and the difference was not statistically significant(P＞0.05).The Gartland Werley wrist joint function score of 21 patients showed excellent results in 21 cases and good results in 0 cases,with an excellent and good rate of 100％.Conclusion The treatment of distal radius fractures in children,especially DRDMJ fractures,with percutaneous Kirschner wire poking reduction and anterograde ESIN has the advantages of minimally invasive,reliable fixation,fewer complications,and good recovery of wrist and forearm rotation function.It is an effective method for treating this type of fractures in children.
childrendistal radius fractureelastic stable intramedullary nail
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