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Órgano Oficial de Difusión Científica de la Federación Mexicana de Colegios de Ortopedia y Traumatología, A.C. (FEMECOT)

2022, Number 3

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Ortho-tips 2022; 18 (3)

Clinicoradiological results in patients operated with Kirschner nails in fractures of the forearm at the National Institute of Pediatrics during the period 2017-2019

Lechuga GR

Language: Spanish
References: 24
Page: 192-199
PDF size: 168.30 Kb.


ABSTRACT

Introduction: Trauma is the leading cause of visits to pediatric emergency rooms, with an estimated annual rate of fractures between 12-36.1 per 1,000 children. Radius and ulna fractures are a frequent pathology treated in the emergency department of this unit. In our hospital, a total of 46 open or closed reductions with internal fixation were performed in 2017, in 2018, 42 cases and in 2019, 51 cases. Therefore, this work will be carried out in search of the results obtained in those patients who underwent surgery for diaphyseal forearm fractures. Evaluating the clinical radiological results of operated patients will allow to know if the results obtained in this unit are similar to those reported in the national and international literature. This will help us identify areas of opportunity to implement standardized management for forearm fracture patients. Objective: To determine the clinical-radiological results in forearm fractures operated with Kirschner nails at the Instituto Nacional de Pediatría during the period 2017-2019. Material and methods: Observational, retrospective and descriptive research, where the information unit will be the electronic medical record of patients who meet the following criteria: complete according to NOM 004, diagnosed with forearm fracture, operated on open reduction or closed and fixation with Kirschner nails at the Instituto Nacional de Pediatría during the period 2017-2019. Results: A total of 139 cases were identified that met the inclusion criteria, frequencies of the affected sex, side and fractured area were found similar to those reported in other series. Only one case presented complications, this being an exposed fracture with subsequent wound dehiscence. The healing time was increased in patients with exposed fractures and in those in whom open reduction was performed. Conclusions: In the present study it was found that the clinical and radiological results of these patients are good in almost all cases, comparable to that reported in the national and international literature. Closed reduction obtains shorter consolidation times, as well as fewer complications.


REFERENCES

  1. Naranje SM, Erali RA, Warner WC Jr, Sawyer JR, Kelly DM. Epidemiology of pediatric fractures presenting to emergency departments in the united states. J Pediatr Orthop. 2016; 36 (4): e45-e48. doi: 10.1097/BPO.0000000000000595.

  2. Landin LA. Epidemiology of children's fractures. J Pediatr Orthop B. 1997; 6 (2): 79-83. doi: 10.1097/01202412-199704000-00002.

  3. McGinley JC, Hopgood BC, Gaughan JP, Sadeghipour K, Kozin SH. Forearm and elbow injury: the influence of rotational position. J Bone Joint Surg Am. 2003; 85 (12): 2403-2409.

  4. Flynn J, Skaggs DL, Waters PM. Rockwood and Wilkins' fractures in children. 8th ed. Philadelphia, PA, USA: Lippincott Williams and Wilkins; 2014. Pp. 413-473.

  5. Jouvejl G, Bollinig P. Fracturesdel'avant-bras chez l'enfant. En: Appareil Locomoteur. Paris: Elsevier Masson SAS; 1997. Pp. 14-045.

  6. Borden S. Traumatic bowing of the forearm in children. J Bone Jt Surg. 1974; 56 (3): 611-616.

  7. Sanders WE, Heckman JD. Traumatic plastic deformation of the radius and ulna. A closed method of correction of deformity. Clin Orthop Relat Res. 1984; (188): 58-67.

  8. Schmuck T, Altermatt S, Büchler P, Klima-Lange D, Krieg A, Lutz N, et al. Greenstick fractures of the middle third of the forearm. A prospective multi-centre study. Eur J Pediatr Surg. 2010; 20 (5): 316-320.

  9. Gupta RP, Danielsson LG. Dorsally angulated solitary metaphyseal greenstick fractures in the distal radius: results after immobilization in pronated, neutral, and supinated position. J Pediatr Orthop. 1990; 10 (1): 90-92.

  10. Wenger DR, Rang M, Pring ME. Rang's children's fractures. 3rd ed. Philadelphia, PA, USA: Lippincott Williams and Wilkins; 2005. p. 126.

  11. Vittas D, Larsen E, Torp-Pedersen S. Angular remodeling of midshaft forearm fractures in children. Clin Orthop Relat Res. 1991; 265 (265): 261-264.

  12. Larsen E, Vittas D, Torp-Pedersen S. Remodeling of angulated distal forearm fractures in children. Clin Orthop Relat Res. 1988; 237 (237): 190-195.

  13. Gibon E, Béranger JS, Bachy M, Delpont M, Kabbaj R, Vialle R. Influence of the bending of the tip of elastic stable intramedullary nails on removal and associated complications in pediatric both bone forearm fractures: a pilot study. Int J Surg. 2015; 16 (Pt A): 19-22.

  14. Boyer BA, Overton B, Schrader W, Riley P, Fleissner P. Position of immobilization for pediatric forearm fractures. J Pediatr Orthop. 2002; 22 (2): 185-187.

  15. Metaizeau JP, Ligier JN. Surgical treatment of fractures of the long bones in children. Interference between osteosynthesis and the physiological processes of consolidation. Therapeutic indications. J Chir (Paris). 1984; 121 (8-9): 527-537.

  16. Griffet J, El Hayek T, Baby M. Intramedullary nailing of forearm fractures in children. J Pediatr Orthop B. 1999; 8 (2): 88-89.

  17. Lascombes P, Prevot J, Ligier JN, Metaizeau JP, Poncelet T. Elastic stable intramedullary nailing in forearm shaft fractures in children: 85 cases. J Pediatr Orthop. 1990; 10 (2): 167-171.

  18. Makki D, Matar HE, Webb M, Wright DM, James LA, Ricketts DM. Elastic stable intramedullary nailing in paediatric forearm fractures: the rate of open reduction and complications: The rate of open reduction and complications. J Pediatr Orthop B. 2017; 26 (5): 412-416.

  19. Nielsen AB, Simonsen O. Displaced forearm fractures in children treated with AO plates. Injury. 1984; 15 (6): 393-396.

  20. Wyrsch B, Mencio GA, Green NE. Open reduction and internal fixation of pediatric forearm fractures. J Pediatr Orthop. 1996;16 (5): 644-650.

  21. Deluca PA, Lindsey RW, Ruwe PA. Refracture of bones of the forearm after the removal of compression plates. J Bone Joint Surg Am. 1988; 70 (9): 1372-1376.

  22. Herman MJ, Simon M, Mehlman CT. The community orthopaedic surgeon taking trauma call: Pediatric forearm shaft fracture pearls and pitfalls: pediatric forearm shaft fracture pearls and pitfalls. J Orthop Trauma. 2017; 31 (6): S6-S10.

  23. Fernandez ML, Segal LS. Entrapment of the flexor digitorum profundus following paediatric forearm fractures. Acta Orthop Belg. 2007; 73 (6): 780-784.

  24. Matthews LS, Kaufer H, Garver DF, Sonstegard DA. The effect on supination-pronation of angular malalignment of fractures of both bones of the forearm. J Bone Joint Surg Am. 1982; 64 (1): 14-17.




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