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Percutaneous leverage technique for reduction of radial neck fractures in children: technical tips
PURPOSE: Paediatric radial neck fractures are challenging to treat. Multiple strategies exist for reduction and fixation; there is no clear consensus on the best surgical technique to achieve reduction. The percutaneous leverage technique is a method for reduction of radial neck fractures that has p...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The British Editorial Society of Bone & Joint Surgery
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7184647/ https://www.ncbi.nlm.nih.gov/pubmed/32351624 http://dx.doi.org/10.1302/1863-2548.14.190130 |
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author | Watkins, Colyn J. Yeung, Caleb M. Rademacher, Emily Kramer, Dennis E. |
author_facet | Watkins, Colyn J. Yeung, Caleb M. Rademacher, Emily Kramer, Dennis E. |
author_sort | Watkins, Colyn J. |
collection | PubMed |
description | PURPOSE: Paediatric radial neck fractures are challenging to treat. Multiple strategies exist for reduction and fixation; there is no clear consensus on the best surgical technique to achieve reduction. The percutaneous leverage technique is a method for reduction of radial neck fractures that has previously been described by Wallace, though there is a lack of published literature on this technique. We present a technical note and a modest case series on our modification to the percutaneous leverage technique accompanied by intramedullary fixation. METHODS: We describe a retrospective series of patients who underwent the modified percutaneous leverage technique for paediatric radial neck fracture reduction followed by flexible intramedullary nail fixation at a single Level I trauma centre from 2008 to 2016. This technique involves making a small incision over the dorsal border of the ulna and using a blunt curved surgical forceps to dissect towards the ulnar border of the radius just distal to the radial neck fracture site. The curved forceps is then used to push the radial shaft away from the ulnar shaft which reduces the radial neck fracture. Intramedullary fixation is then utilized to stabilize the reduction. Pre- and postoperative radiographs and clinical data from the medical record were reviewed, and patient, injury and treatment characteristics as well as complication rates are summarized. RESULTS: We successfully treated a series of eight radial neck fractures with the modified percutaneous leverage technique. This technique allows for a small incision and a minimally invasive method for the reduction of paediatric radial neck fractures. This allowed for subsequent intramedullary fixation and early postoperative elbow mobilization. In our series, no patients developed synostoses or sustained peripheral nerve injuries using this technique. CONCLUSION: The modified percutaneous leverage technique followed by intramedullary fixation is a safe and effective technique for fixation of displaced paediatric radial neck fractures. LEVEL OF EVIDENCE: Level IV |
format | Online Article Text |
id | pubmed-7184647 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | The British Editorial Society of Bone & Joint Surgery |
record_format | MEDLINE/PubMed |
spelling | pubmed-71846472020-04-29 Percutaneous leverage technique for reduction of radial neck fractures in children: technical tips Watkins, Colyn J. Yeung, Caleb M. Rademacher, Emily Kramer, Dennis E. J Child Orthop Technical Note PURPOSE: Paediatric radial neck fractures are challenging to treat. Multiple strategies exist for reduction and fixation; there is no clear consensus on the best surgical technique to achieve reduction. The percutaneous leverage technique is a method for reduction of radial neck fractures that has previously been described by Wallace, though there is a lack of published literature on this technique. We present a technical note and a modest case series on our modification to the percutaneous leverage technique accompanied by intramedullary fixation. METHODS: We describe a retrospective series of patients who underwent the modified percutaneous leverage technique for paediatric radial neck fracture reduction followed by flexible intramedullary nail fixation at a single Level I trauma centre from 2008 to 2016. This technique involves making a small incision over the dorsal border of the ulna and using a blunt curved surgical forceps to dissect towards the ulnar border of the radius just distal to the radial neck fracture site. The curved forceps is then used to push the radial shaft away from the ulnar shaft which reduces the radial neck fracture. Intramedullary fixation is then utilized to stabilize the reduction. Pre- and postoperative radiographs and clinical data from the medical record were reviewed, and patient, injury and treatment characteristics as well as complication rates are summarized. RESULTS: We successfully treated a series of eight radial neck fractures with the modified percutaneous leverage technique. This technique allows for a small incision and a minimally invasive method for the reduction of paediatric radial neck fractures. This allowed for subsequent intramedullary fixation and early postoperative elbow mobilization. In our series, no patients developed synostoses or sustained peripheral nerve injuries using this technique. CONCLUSION: The modified percutaneous leverage technique followed by intramedullary fixation is a safe and effective technique for fixation of displaced paediatric radial neck fractures. LEVEL OF EVIDENCE: Level IV The British Editorial Society of Bone & Joint Surgery 2020-04-01 /pmc/articles/PMC7184647/ /pubmed/32351624 http://dx.doi.org/10.1302/1863-2548.14.190130 Text en Copyright © 2020, The author(s) http://creativecommons.org/licenses/by-nc/4.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed. |
spellingShingle | Technical Note Watkins, Colyn J. Yeung, Caleb M. Rademacher, Emily Kramer, Dennis E. Percutaneous leverage technique for reduction of radial neck fractures in children: technical tips |
title | Percutaneous leverage technique for reduction of radial neck fractures in children: technical tips |
title_full | Percutaneous leverage technique for reduction of radial neck fractures in children: technical tips |
title_fullStr | Percutaneous leverage technique for reduction of radial neck fractures in children: technical tips |
title_full_unstemmed | Percutaneous leverage technique for reduction of radial neck fractures in children: technical tips |
title_short | Percutaneous leverage technique for reduction of radial neck fractures in children: technical tips |
title_sort | percutaneous leverage technique for reduction of radial neck fractures in children: technical tips |
topic | Technical Note |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7184647/ https://www.ncbi.nlm.nih.gov/pubmed/32351624 http://dx.doi.org/10.1302/1863-2548.14.190130 |
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