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Retrograde intramedullary nailing of the radius in children: A pilot magnetic resonance imaging study of soft-tissue findings

PURPOSE: Unstable forearm shaft fractures in children are preferably treated surgically using elastic stable intramedullary nails. The radius is nailed retrograde from the distal metaphysis. There is a risk of surgery-related soft-tissue complications during the operation. Close evaluation of occult...

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Autores principales: Perhomaa, Marja, Kyrö, Antti, Niinimäki, Jaakko, Sinikumpu, Juha-Jaakko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9382708/
https://www.ncbi.nlm.nih.gov/pubmed/35992516
http://dx.doi.org/10.1177/18632521221114553
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author Perhomaa, Marja
Kyrö, Antti
Niinimäki, Jaakko
Sinikumpu, Juha-Jaakko
author_facet Perhomaa, Marja
Kyrö, Antti
Niinimäki, Jaakko
Sinikumpu, Juha-Jaakko
author_sort Perhomaa, Marja
collection PubMed
description PURPOSE: Unstable forearm shaft fractures in children are preferably treated surgically using elastic stable intramedullary nails. The radius is nailed retrograde from the distal metaphysis. There is a risk of surgery-related soft-tissue complications during the operation. Close evaluation of occult surgery-related soft-tissue lesions has not been possible previously, due to the titanium alloy hardware used in the process. The aim of the present study was to evaluate the potential findings in the surrounding soft tissues after intramedullary nailing of the radius, by using magnetic resonance imaging. METHODS: The study population comprised 15 pediatric patients with forearm shaft fractures treated by polylactide-co-glycolide biodegradable intramedullary nails and postoperatively evaluated via magnetic resonance imaging. The main outcome was signal abnormality in any tendon at the entry point postoperatively. Secondarily, other changes in the soft tissues related to nailing were determined. Furthermore, the precise location of the entry point and the anatomic characteristics of the soft-tissue tunnel were described. RESULTS: In total, 5 of 15 patients (33.3%) had transient signal pathology in a tendon postoperatively. Edema around the superficial radial nerve was detected in 13 of 15 patients (86.7%). The most common surgical approach was between the extensor pollicis brevis and the extensor carpi radialis longus tendons, which was applied in 10 of 15 patients (66.7%). CONCLUSIONS: One in three patients exhibited transient and occult surgery-related intraparenchymal signal pathology in a tendon, after forearm intramedullary nailing. Caution with surgical prepare of the soft-tissue cleavage is recommended. LEVEL OF EVIDENCE: IV
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spelling pubmed-93827082022-08-18 Retrograde intramedullary nailing of the radius in children: A pilot magnetic resonance imaging study of soft-tissue findings Perhomaa, Marja Kyrö, Antti Niinimäki, Jaakko Sinikumpu, Juha-Jaakko J Child Orthop Trauma PURPOSE: Unstable forearm shaft fractures in children are preferably treated surgically using elastic stable intramedullary nails. The radius is nailed retrograde from the distal metaphysis. There is a risk of surgery-related soft-tissue complications during the operation. Close evaluation of occult surgery-related soft-tissue lesions has not been possible previously, due to the titanium alloy hardware used in the process. The aim of the present study was to evaluate the potential findings in the surrounding soft tissues after intramedullary nailing of the radius, by using magnetic resonance imaging. METHODS: The study population comprised 15 pediatric patients with forearm shaft fractures treated by polylactide-co-glycolide biodegradable intramedullary nails and postoperatively evaluated via magnetic resonance imaging. The main outcome was signal abnormality in any tendon at the entry point postoperatively. Secondarily, other changes in the soft tissues related to nailing were determined. Furthermore, the precise location of the entry point and the anatomic characteristics of the soft-tissue tunnel were described. RESULTS: In total, 5 of 15 patients (33.3%) had transient signal pathology in a tendon postoperatively. Edema around the superficial radial nerve was detected in 13 of 15 patients (86.7%). The most common surgical approach was between the extensor pollicis brevis and the extensor carpi radialis longus tendons, which was applied in 10 of 15 patients (66.7%). CONCLUSIONS: One in three patients exhibited transient and occult surgery-related intraparenchymal signal pathology in a tendon, after forearm intramedullary nailing. Caution with surgical prepare of the soft-tissue cleavage is recommended. LEVEL OF EVIDENCE: IV SAGE Publications 2022-08-02 2022-08 /pmc/articles/PMC9382708/ /pubmed/35992516 http://dx.doi.org/10.1177/18632521221114553 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (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 as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Trauma
Perhomaa, Marja
Kyrö, Antti
Niinimäki, Jaakko
Sinikumpu, Juha-Jaakko
Retrograde intramedullary nailing of the radius in children: A pilot magnetic resonance imaging study of soft-tissue findings
title Retrograde intramedullary nailing of the radius in children: A pilot magnetic resonance imaging study of soft-tissue findings
title_full Retrograde intramedullary nailing of the radius in children: A pilot magnetic resonance imaging study of soft-tissue findings
title_fullStr Retrograde intramedullary nailing of the radius in children: A pilot magnetic resonance imaging study of soft-tissue findings
title_full_unstemmed Retrograde intramedullary nailing of the radius in children: A pilot magnetic resonance imaging study of soft-tissue findings
title_short Retrograde intramedullary nailing of the radius in children: A pilot magnetic resonance imaging study of soft-tissue findings
title_sort retrograde intramedullary nailing of the radius in children: a pilot magnetic resonance imaging study of soft-tissue findings
topic Trauma
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9382708/
https://www.ncbi.nlm.nih.gov/pubmed/35992516
http://dx.doi.org/10.1177/18632521221114553
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