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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.
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.
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