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欢迎您 王李钢 来自 广州中医药大学
广州中医药大学
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,2024 Mar;144(3):1179-1188. doi: 10.1007/s00402-023-05118-z. Epub 2024 Jan 17. Therapeutic approaches of diametaphyseal radius fractures in children
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Authors

Affiliations

1.Klinik für Kinderchirurgie, Klinik St. Hedwig, Krankenhaus der Barmherzigen Brüder, Steinmetzstr. 1-3, 93047, Regensburg, Germany. Domitille.Stark@barmherzige-regensburg.de.

2.Klinik für Kinderchirurgie, Klinik St. Hedwig, Krankenhaus der Barmherzigen Brüder, Steinmetzstr. 1-3, 93047, Regensburg, Germany.

3.Klinik für Radiologie, Krankenhaus der Barmherzigen Brüder, Regensburg, Germany.

PMID:38231205PMCID:DOI:10.1007/s00402-023-05118-z
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Abstract

Results: During the study period, 547 patients presented with forearm fractures of which 88 patients (16%) had a fracture in the diametaphyseal region. The majority of diametaphyseal fractures were greenstick fractures (54.4%) followed by transverse fractures (44.3%). Distal fractures were predominantly treated with bicortical K-wiring (BC-KW, 40.5%) or non-surgically (C, 26.2%). Proximal fractures were treated by ESIN osteosynthesis (50%), followed by IM-KW (30%). Intermediate fractures were just as likely to be treated with one out of the 5 above-mentioned techniques. The ulna was involved in 64 of 88 cases. Depending on the type of fracture, it was treated either by ESIN osteosynthesis or non-surgically. No superior operative technique was identified.

Conclusions: The description of diametaphyseal fractures as a separate entity is important, because the therapy of these fractures is heterogeneous and challenging. A classification into proximal, intermediate, and distal may be useful in clinical decision-making. Despite the retrospective nature of this study, our data suggest that the use of a K-wire or combined technique BCIM-KW-technique, whenever technically feasible, achieves better radiological results without secondary dislocation. Further prospective studies are needed to provide better guidance to trauma surgeons.

Keywords: Bicortical; Diametaphysis; ESIN; Forearm; Intramedullary; Kirschner wire; Pediatric trauma.

References

1.
Handoll HH, Elliott J, Iheozor-Ejiofor Z, Hunter J, Karantana A (2018) Interventions for treating wrist fractures in children. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD012470.pub2-DOI-PubMed-PMC
2.
Lieber J, Sommerfeldt DW (2011) Die diametaphysäre Unterarmfraktur im Kindesalter. Unfallchirurg 114(4):292–299. https://doi.org/10.1007/s00113-011-1962-5-DOI-PubMed
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Schneidmüller D, Marzi I (2011) Grundprinzipien der Kindertraumatologie. In: Orthopädie und Unfallchirurgie, Springer-Verlag
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Pritchett JW (1991) Growth plate activity in the upper extremity. Clin Orthop Relat Res 268:235–242
5.
Dietz HG, Illing P, Schmittenbecher PP, Slongo Th, Sommerfeldt DW (2011) Praxis der Kinder- und Jugendtraumatologie, Springer-Verlag

MeSH terms

Bone Nails
Child
Forearm Injuries* / complications
Forearm Injuries* / surgery
Fracture Fixation, Internal
Fracture Fixation, Intramedullary* / adverse effects
Humans
Radius
Radius Fractures* / diagnostic imaging
Radius Fractures* / surgery
Retrospective Studies
Treatment Outcome

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