Journal List > J Korean Fract Soc > v.28(4) > 1038038

Lee, Jeong, Park, Lee, Oh, Lee, and Jeon: Operative Treatment of Pediatric Distal Forearm Bothbone Fracture

Abstract

Purpose

Pediatric patients with distal forearm bothbone fractures of surgical indication were treated with the Kapandji reduction technique for radius and flexible intramedullary nail for ulna at our institution. The purpose of this study is to evaluate clinical and radiological results.

Materials and Methods

From February 2012 to June 2014, we retrospectively evaluated 16 out of 18 cases with distal forearm bothbone fractures treated with the Kapandji reduction technique for radius and flexible intramedullary nail for ulna with at least 1-year follow-up. The average age at operation was 9.1 years (7-13 years).

Results

Adequate reduction for both radius and ulna was achieved for all cases, and none of the cases showed re-displacement until the last follow-up. Mean 6.6 weeks lapsed until bony union was observed for the radius. For the ulna, the mean was 6.5 weeks. All patients gained full wrist range of motion at the last visit.

Conclusion

For pediatric distal forearm bothbone fractures, intrafocal Kapandji reduction and internal fixation with Kirschner wire for radius and reduction and internal fixation with a flexible intramedullary nail for ulna is the technique for handy reduction. Use of this technique can prevent re-displacement during the union process and achieve excellent clinical and radiologic results.

Figures and Tables

Fig. 1

(A) Pin-leverage technique to lever up the distal fragment of the radius. (B) Nancy nail™ (flexible intramedullary nail) is inserted toward distal fragment (arrow) to achieve reduction.

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Fig. 2

Measurement of displacement (%). a: width of proximal segment, b: displaced distance.

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Fig. 3

(A) Both distal radius and ulna fracture of an 11-year-old boy. (B) Immediate postoperative X-ray. (C) Eight months after surgery.

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Table 1

Radiographic Measurements

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Notes

Financial support None.

Conflict of interest None.

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