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Cast immobilization in bayonet position versus reduction and pin fixation of overriding distal metaphyseal radius fractures in children under ten years of age: a case control study

PURPOSE: Completely displaced distal radius fractures in children have been traditionally reduced and immobilized with a cast or pin fixed. Cast immobilization leaving the fracture displaced in the bayonet position has been recently suggested as a non-invasive and effective treatment alternative. Th...

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Autores principales: Laaksonen, Topi, Puhakka, Jani, Stenroos, Antti, Kosola, Jussi, Ahonen, Matti, Nietosvaara, Yrjänä
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The British Editorial Society of Bone & Joint Surgery 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7907764/
https://www.ncbi.nlm.nih.gov/pubmed/33643460
http://dx.doi.org/10.1302/1863-2548.15.200171
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author Laaksonen, Topi
Puhakka, Jani
Stenroos, Antti
Kosola, Jussi
Ahonen, Matti
Nietosvaara, Yrjänä
author_facet Laaksonen, Topi
Puhakka, Jani
Stenroos, Antti
Kosola, Jussi
Ahonen, Matti
Nietosvaara, Yrjänä
author_sort Laaksonen, Topi
collection PubMed
description PURPOSE: Completely displaced distal radius fractures in children have been traditionally reduced and immobilized with a cast or pin fixed. Cast immobilization leaving the fracture displaced in the bayonet position has been recently suggested as a non-invasive and effective treatment alternative. This is a pilot comparative study between reduction and no reduction. METHODS: We assessed subjective, functional and radiographic outcome after a minimum 2.5-year follow-up in 12 children under ten years of age who had sustained a completely displaced metaphyseal radius fracture, which had been immobilized leaving the fracture in an overriding position (shortening 3 mm to 9 mm). A total of 12 age-matched patients, whose similar fractures were reduced and pin fixed, were chosen for controls. RESULTS: At follow-up none of the 24 patients had visible forearm deformity and the maximal angulation in radiographs was 5° Forearm and wrist movement was restored (< 10° of discrepancy) in all 24 patients. Grip strength ratio was normal in all but three surgically treated patients. All patients had returned to their previous activities. One operatively treated boy who was re-operated on reported of pain (visual analogue scale 2). CONCLUSION: The results of this study do not demonstrate the superiority of reduction and pin fixation over cast immobilization in the bayonet position of closed overriding distal metaphyseal radius fractures in children under ten years with normal neurovascular findings. LEVEL OF EVIDENCE: III
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spelling pubmed-79077642021-02-26 Cast immobilization in bayonet position versus reduction and pin fixation of overriding distal metaphyseal radius fractures in children under ten years of age: a case control study Laaksonen, Topi Puhakka, Jani Stenroos, Antti Kosola, Jussi Ahonen, Matti Nietosvaara, Yrjänä J Child Orthop Original Clinical Article PURPOSE: Completely displaced distal radius fractures in children have been traditionally reduced and immobilized with a cast or pin fixed. Cast immobilization leaving the fracture displaced in the bayonet position has been recently suggested as a non-invasive and effective treatment alternative. This is a pilot comparative study between reduction and no reduction. METHODS: We assessed subjective, functional and radiographic outcome after a minimum 2.5-year follow-up in 12 children under ten years of age who had sustained a completely displaced metaphyseal radius fracture, which had been immobilized leaving the fracture in an overriding position (shortening 3 mm to 9 mm). A total of 12 age-matched patients, whose similar fractures were reduced and pin fixed, were chosen for controls. RESULTS: At follow-up none of the 24 patients had visible forearm deformity and the maximal angulation in radiographs was 5° Forearm and wrist movement was restored (< 10° of discrepancy) in all 24 patients. Grip strength ratio was normal in all but three surgically treated patients. All patients had returned to their previous activities. One operatively treated boy who was re-operated on reported of pain (visual analogue scale 2). CONCLUSION: The results of this study do not demonstrate the superiority of reduction and pin fixation over cast immobilization in the bayonet position of closed overriding distal metaphyseal radius fractures in children under ten years with normal neurovascular findings. LEVEL OF EVIDENCE: III The British Editorial Society of Bone & Joint Surgery 2021-02-01 /pmc/articles/PMC7907764/ /pubmed/33643460 http://dx.doi.org/10.1302/1863-2548.15.200171 Text en Copyright © 2021, 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 Original Clinical Article
Laaksonen, Topi
Puhakka, Jani
Stenroos, Antti
Kosola, Jussi
Ahonen, Matti
Nietosvaara, Yrjänä
Cast immobilization in bayonet position versus reduction and pin fixation of overriding distal metaphyseal radius fractures in children under ten years of age: a case control study
title Cast immobilization in bayonet position versus reduction and pin fixation of overriding distal metaphyseal radius fractures in children under ten years of age: a case control study
title_full Cast immobilization in bayonet position versus reduction and pin fixation of overriding distal metaphyseal radius fractures in children under ten years of age: a case control study
title_fullStr Cast immobilization in bayonet position versus reduction and pin fixation of overriding distal metaphyseal radius fractures in children under ten years of age: a case control study
title_full_unstemmed Cast immobilization in bayonet position versus reduction and pin fixation of overriding distal metaphyseal radius fractures in children under ten years of age: a case control study
title_short Cast immobilization in bayonet position versus reduction and pin fixation of overriding distal metaphyseal radius fractures in children under ten years of age: a case control study
title_sort cast immobilization in bayonet position versus reduction and pin fixation of overriding distal metaphyseal radius fractures in children under ten years of age: a case control study
topic Original Clinical Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7907764/
https://www.ncbi.nlm.nih.gov/pubmed/33643460
http://dx.doi.org/10.1302/1863-2548.15.200171
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