Hu Wenfeng,Li Tianyou,Wang Yanzhou,et al.Nonunion of distal radius fractures in children:a report of three cases with a literature review[J].Journal of Clinical Pediatric Surgery,,21():1179-1184.[doi:10.3760/cma.j.cn101785-202105060-015]
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Nonunion of distal radius fractures in children:a report of three cases with a literature review

Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R] volume: 第21卷 Number: 2022 12 Page: 1179-1184 Column: 临床研究与实践 Date of publication: 1900-01-01
Author(s):
Hu Wenfeng1; 2;  Li Tianyou3;  Wang Yanzhou3;  Wang Hengbing3
1 School of Nursing & Rehabilitation, Shandong University, Jinan 250012, China;
2 Department of Healthcare Surgery, Affiliated Shandong Provincial Hospital, Shandong First Medical University, Jinan 250021, China;
3 Department of Pediatric Orthopedics, Affiliated Shandong Provincial Hospital, Shandong First Medical University, Jinan 250021, China
Keywords:
Radius Fractures; Orthopedic Procedures; Treatment Outcome; Child
DOI:
10.3760/cma.j.cn101785-202105060-015
Abstract:
Objective To explore the predilection sites and causes of distal radius nonunion in children.Methods From May 2013 to March 2021,clinical data were retrospectively reviewed for three children with nonunion of distal radius fracture.The relevant literatures were retrieved from the databases of PubMed,WanFang and CNKI prior to March 2021.Gender,age,fracture type and treatment option were analyzed.Results Open reduction and Kirschner wire fixation were performed initially.Nonunion occurred after ineffective conservative treatment.Two cases were re-operated and healed while another one case refused any further intervention.By searching the database,5 relevant items (8 cases) were included.Altogether there were 9 boys and 2 girls with an average age of 107(72-156) months.All fractures were totally displaced with distal ulna fracture.The involved side was left (n=4),right (n=2) and unknown (n=6).Open reduction plus Kirschner wire fixation (n=7),open reduction plus plate fixation (n=1) and closed reduction with cast immobilization (n=2) were performed.Ten patients were re-operated due to nonunion and healed during follow-ups.Six cases underwent open reduction plus autologous iliac bone graft,including plate fixation (n=3),external fixator (n=1),Kirschner wire (n=1) and casting (n=1).Open reduction plus plate fixation (n=3) and closed reduction plus Kirschner wire fixation (n=1) were performed.According to the Lieber’s criteria,there were epiphyseal fracture (n=1) and diametaphyseal fractures (n=10).Conclusion Distal radius nonunion affects mostly diametaphyseal area.To prevent nonunion,more attention should be focused upon this area.For open reduction,anatomical reduction plus stable fixation should be considered along with close follow-ups.

References:

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Memo

收稿日期:2021-5-31。
基金项目:国家重点研发计划(2016YFC0901503)
通讯作者:李天友,Email:tianyouli1983@126.com

Last Update: 1900-01-01