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Percutaneous k-wire leverage reduction and retrograde transphyseal k-wire fixation of angulated radial neck fractures in children

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

To describe clinical and radiographic outcomes after surgical management of angulated radial neck fracture in children.

Methods

Twenty children (aged 2–11 years) with angulated radial neck fracture with more than 30° angulations (Judet type III and IV fractures) were retrospectively reviewed. All the enrolled patients were surgically treated with percutaneous k-wire leverage reduction and retrograde transphyseal k-wire fixation. Clinical outcomes were evaluated using Tibone and Stoltz score and the Mayo Elbow Performance Score (MEPS). Radiographic outcomes were evaluated with Métaizeau score. Complications were also evaluated.

Results

At a mean follow-up of 20 months, no patients showed axial deformity of the upper limb or instability of the elbow. The mean value of the MEPS was 99.2, and excellent clinical results were achieved in 14 patients (73.7%) at Tibone and Stoltz score. The final X-rays showed fracture healing in all patients; furthermore, 75% of patients showed excellent reduction at Métaizeau score. No patient developed complication. There were no iatrogenic nerve injuries or pin infections.

Conclusions

The results demonstrate that percutaneous k-wire leverage reduction and retrograde transphyseal k-wire fixation of angulated radial neck fracture treatment is a simple, effective, rapid and inexpensive procedure.

Level of evidence

IV (case series and systematic review of level IV studies).

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Authors and Affiliations

  1. Clinical Orthopaedics, Department of Clinical and Molecular Sciences, School of Medicine, Università Politecnica delle Marche, Via Conca, Torrette, 60100, Ancona, Italy

    Daniele Massetti, Giulia Facco, Nicola Specchia & Antonio Pompilio Gigante

  2. Clinic of Adult and Paediatric Orthopaedics, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Ancona, Ancona, Italy

    Mario Marinelli, Danya Falcioni & Nicola Giampaolini

Authors
  1. Daniele Massetti
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  2. Mario Marinelli
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  3. Giulia Facco
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  4. Danya Falcioni
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  5. Nicola Giampaolini
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  6. Nicola Specchia
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  7. Antonio Pompilio Gigante
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Correspondence to Daniele Massetti.

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Daniele Massetti, Mario Marinelli, Giulia Facco, Danya Falcioni, Nicola Giampaolini, Nicola Specchia, Antonio Pompilio Gigante declare that they have no conflict of interest and have not received financial remuneration.

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Massetti, D., Marinelli, M., Facco, G. et al. Percutaneous k-wire leverage reduction and retrograde transphyseal k-wire fixation of angulated radial neck fractures in children. Eur J Orthop Surg Traumatol 30, 931–937 (2020). https://doi.org/10.1007/s00590-020-02654-x

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  • DOI: https://doi.org/10.1007/s00590-020-02654-x

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