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Radial vs. Dorsal Approach for Elastic Stable Internal Nailing in Pediatric Radius Fractures—A 10 Year Review
Background: Forearm fractures are one of the most common fractures in children. Over the last years, a tendency towards surgical treatment was seen, especially closed reduction and internal fixation with elastic stable internal nailing (ESIN). Despite an overall low complication rate being described...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9369287/ https://www.ncbi.nlm.nih.gov/pubmed/35956095 http://dx.doi.org/10.3390/jcm11154478 |
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author | Cintean, Raffael Eickhoff, Alexander Pankratz, Carlos Strauss, Beatrice Gebhard, Florian Schütze, Konrad |
author_facet | Cintean, Raffael Eickhoff, Alexander Pankratz, Carlos Strauss, Beatrice Gebhard, Florian Schütze, Konrad |
author_sort | Cintean, Raffael |
collection | PubMed |
description | Background: Forearm fractures are one of the most common fractures in children. Over the last years, a tendency towards surgical treatment was seen, especially closed reduction and internal fixation with elastic stable internal nailing (ESIN). Despite an overall low complication rate being described, a risk of intraoperative complications remains. Material and Methods: A total of 237 patients (mean age 8.3 ± 3.4 (1–16) years) with forearm or radius fractures treated with ESIN between 2010 and 2020 were included in the study. The retrospective review of 245 focused on fracture pattern, pre- and postoperative fracture angulation, intra- and postoperative complications, and surgical approach for nail implant. The fracture pattern and pre- and postoperative angulation were measured radiographically. Complications such as ruptures of the extensor pollicis longus (EPL) tendon and sensibility disorders of the superficial radial nerve were further analyzed. Results: In 201 cases (82%), we performed a dorsal approach; 44 fractures (17.9%) were treated with a radial approach. In total, we found 25 (10%) surgery-related complications, of which 21 (8.6%) needed further surgical treatment. In total, we had 14 EPL ruptures (5.7%), 4 sensibility disorders of the superficial radial nerve (1.6%), 2 refractures after implant removal (0.8%), 2 superficial wound infections (0.8%), and 1 child with limited range of motion after surgery (0.4%). No statistical significance between pre- and postoperative angulation correlated to fracture patterns or diameter of the elastic nail was seen. As expected, there was a significant improvement of postoperative angulation. Using radial approach in distal radial fractures showed a lower rate of surgical related complications, 2.3% of which need further surgical treatment as well as better postoperative angulations compared to the dorsal approach (8.5%). Conclusion: Especially due to the low risk of damaging the EPL tendon, the radial approach showed a lower complication rate which needed further surgical treatment. The risk of lesions of the superficial radial nerve remains. |
format | Online Article Text |
id | pubmed-9369287 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-93692872022-08-12 Radial vs. Dorsal Approach for Elastic Stable Internal Nailing in Pediatric Radius Fractures—A 10 Year Review Cintean, Raffael Eickhoff, Alexander Pankratz, Carlos Strauss, Beatrice Gebhard, Florian Schütze, Konrad J Clin Med Article Background: Forearm fractures are one of the most common fractures in children. Over the last years, a tendency towards surgical treatment was seen, especially closed reduction and internal fixation with elastic stable internal nailing (ESIN). Despite an overall low complication rate being described, a risk of intraoperative complications remains. Material and Methods: A total of 237 patients (mean age 8.3 ± 3.4 (1–16) years) with forearm or radius fractures treated with ESIN between 2010 and 2020 were included in the study. The retrospective review of 245 focused on fracture pattern, pre- and postoperative fracture angulation, intra- and postoperative complications, and surgical approach for nail implant. The fracture pattern and pre- and postoperative angulation were measured radiographically. Complications such as ruptures of the extensor pollicis longus (EPL) tendon and sensibility disorders of the superficial radial nerve were further analyzed. Results: In 201 cases (82%), we performed a dorsal approach; 44 fractures (17.9%) were treated with a radial approach. In total, we found 25 (10%) surgery-related complications, of which 21 (8.6%) needed further surgical treatment. In total, we had 14 EPL ruptures (5.7%), 4 sensibility disorders of the superficial radial nerve (1.6%), 2 refractures after implant removal (0.8%), 2 superficial wound infections (0.8%), and 1 child with limited range of motion after surgery (0.4%). No statistical significance between pre- and postoperative angulation correlated to fracture patterns or diameter of the elastic nail was seen. As expected, there was a significant improvement of postoperative angulation. Using radial approach in distal radial fractures showed a lower rate of surgical related complications, 2.3% of which need further surgical treatment as well as better postoperative angulations compared to the dorsal approach (8.5%). Conclusion: Especially due to the low risk of damaging the EPL tendon, the radial approach showed a lower complication rate which needed further surgical treatment. The risk of lesions of the superficial radial nerve remains. MDPI 2022-07-31 /pmc/articles/PMC9369287/ /pubmed/35956095 http://dx.doi.org/10.3390/jcm11154478 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Cintean, Raffael Eickhoff, Alexander Pankratz, Carlos Strauss, Beatrice Gebhard, Florian Schütze, Konrad Radial vs. Dorsal Approach for Elastic Stable Internal Nailing in Pediatric Radius Fractures—A 10 Year Review |
title | Radial vs. Dorsal Approach for Elastic Stable Internal Nailing in Pediatric Radius Fractures—A 10 Year Review |
title_full | Radial vs. Dorsal Approach for Elastic Stable Internal Nailing in Pediatric Radius Fractures—A 10 Year Review |
title_fullStr | Radial vs. Dorsal Approach for Elastic Stable Internal Nailing in Pediatric Radius Fractures—A 10 Year Review |
title_full_unstemmed | Radial vs. Dorsal Approach for Elastic Stable Internal Nailing in Pediatric Radius Fractures—A 10 Year Review |
title_short | Radial vs. Dorsal Approach for Elastic Stable Internal Nailing in Pediatric Radius Fractures—A 10 Year Review |
title_sort | radial vs. dorsal approach for elastic stable internal nailing in pediatric radius fractures—a 10 year review |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9369287/ https://www.ncbi.nlm.nih.gov/pubmed/35956095 http://dx.doi.org/10.3390/jcm11154478 |
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