Meng Ge,Yuan Yue,Yuan Liang,et al.Efficacy of antegrade elastic intramedullary nailing for severely displaced unstable distal radial metaphyseal junction fracture in children[J].Journal of Clinical Pediatric Surgery,,():872-876.[doi:10.3760/cma.j.cn101785-202211011-013]
Efficacy of antegrade elastic intramedullary nailing for severely displaced unstable distal radial metaphyseal junction fracture in children
- Abstract:
- Objective To explore the clinical efficacy of antegrade elastic intramedullary nailing for severely displaced unstable distal radial metaphyseal junction fracture in children. Methods Retrospective analysis was performed for the relevant clinical data of 46 children with severely displaced unstable distal radial metaphyseal junction fracture undergoing anterograde elastic intramedullary nailing from July 2020 to March 2022.The causes of injury were frolicking falls (n=39), falling from heights (n=3) and traffic accidents (n=4).There were 41 boys and 5 girls with an average age of (9.93±2.67) year.The affected side was left (n=23) and right (n=23).The fractures were closed (n=44) and open (n=2) (surgery after adequate preventive anti-infection).Radial fractures were simple (n=9) and combined with distal ulnar fractures (n=37).Time from injury to surgery was 3.4(1-16) day.Operative duration, number of intraoperative fluoroscopy sessions, length of hospitalization stay and removal time for plaster cast were recorded.The postoperative complications of fractures and the ranges of motion of forearm and wrist joints were followed up.And therapeutic effect was evaluated with the Anderson functional assessment criteria for forearm fractures. Results In this cohort, operative duration was (61.91±27.89) min, number of intraoperative fluoroscopy (20.87±7.43) sessions, length of hospitalization (4.96±1.98) day and removal time for plaster cast (4.24±0.82) week.The follow-up period was (7.98±2.32) month.There were 5 complicated cases, including nail tail irritation (n=3), fracture displacement (n=1) and radial nerve injury (n=1).Delayed or nonunion fracture was absent.At the last follow-up, pronation angle of healthy forearm was (88.67±3.20)°, supination Angle of forearm (85.67±4.74)°, palmar flexion angle of wrist joint (62.22±8.76)°, dorsiflexion angle of wrist joint (67.15±7.42)°, ulnar tilt angle of wrist joint (31.40±4.23)° and radial tilt angle of wrist joint (21.26±3.06)°.Pronation angle of affected forearm was (84.76±4.86)°, supination angle of forearm (84.28±4.79)°, palmar flexion angle of wrist joint (62.67±8.83)°, dorsiflexion angle of wrist joint (66.65±7.38)°, ulnar tilt angle of wrist joint (31.69±3.85)° and radial tilt angle of wrist joint (20.89±2.57)°.No statistically significant difference existed between the two (P>0.05).At the last follow-up, the functional evaluation results of Anderson’s forearm fractures were excellent (n=44) and decent (n=2). Conclusions Anterograde elastic intramedullary nailing is efficacious for severely displaced unstable distal radial metaphyseal junction fractures in children.It offers the advantages of no epiphyseal damage, fewer postoperative complications and excellent functional recovery.
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Memo
收稿日期:2022-11-6。
基金项目:安徽医科大学科学基金项目(2023xkj103)
通讯作者:林昱东，Email: ahpolinyudong@163.com