Escudero RD, Bahena SY

Language: Spanish
References: 15
Page: 279-283
PDF size: 211.12 Kb.

ABSTRACT

Background: Complete fractures of the distal radius are unstable and the standard treatment is to reduce further stabilization. The controversy is whether the immobilization with crossed Kirschner wire and protective splint provides enough stability for adequate functional recovery.
Objective: To determine clinical and radiographic outcomes in children managed with crossed Kirschner wire for diagnosis of distal radius fracture.
Patients and methods: Patients treated at the pediatric orthopedic service from January 2006 to July 2007 were studied. We performed a functional assessment with criteria adapted from Price and a consolidation assessment based on Montoya classification.
Results: Twenty-six patients with a mean age of 12.1 years (88.5% male) were included. The average healing time (consolidation grade IV) was 10.4 weeks. According to criteria of Price, 16 patients had excellent results, eight had good results and two had bad results (angulation greater than 40° and nonunion). Complications were: superficial infection in three patients (11.5%), pins in seven patients (27%), fractures in three (11.5%), Kirschner wires loosing and angular deformities in ten patients (38.4%) and pseudoarthrosis in one patient (3.8%).
Conclusion: This surgical technique is necessary and appropriate for treating unstable distal radius fractures in children; however using only protective splint does not provide enough stability. We suggest changing the protocol for monitoring these patients, placing a plaster cast the first three days after treatment to avoid displacement and deformity that involved prolonged immobilization.

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