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Open Reduction of Displaced Radial Neck Fractures in Children by Internal Fixation Techniques: Comparison of Percutaneous Kirschner Wiring and Elastic Stable Intramedullary Nailing

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Abstracts

Background

Although most paediatric radial neck fractures can be treated with closed reduction, some severely displaced fractures require open reduction. The purpose of this study is to compare the effects of ESIN and KW fixation in open reduction of radial neck fracture in children.

Methods

Twenty-four patients with mean age of 8.5 years were included. Four of the patients had a Judet type III fracture and 20 had a Judet type IV fracture. Ten patients who underwent percutaneous KW fixation were assigned to group A, while 14 patients who underwent ESIN fixation were assigned to group B. Variables of interest included age, sex, fracture type, associated lesions, surgical time, fracture reduction, cost, follow-up, healing time, X-rays, clinical outcomes, and complications.

Results

There were no significant between-group differences in sex, age, additional injuries, fracture type, and quality of reduction. Costs were significantly lower in Group A. Fracture healing was achieved in 23 of 24 patients (10/10 in group A and 13/14 in group B). In a postoperative elbow function assessment based on the Steele and Graham classification, 80% of patients in group A had a score of excellent or good, compared to 78.6% of patients in group B. Two cases of nail shifting and joint protrusion were observed in group B, one of which also presented with nonunion during follow-up.

Conclusions

Both KW and ESIN may achieve good clinical outcomes, but KW is associated with lower costs, easier implant removal (without the need for a secondary surgery), and lower iatrogenic complications.

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Abbreviations

ESIN:

Elastic stable intramedullary nail

KW:

Kirschner wire

AP:

Anteroposterior

SD:

Standard deviation

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Author notes

  1. Yao Liu and Lun-Qin Zhu contributed to the work equally and should be regarded as co-first authors.

Authors and Affiliations

  1. Department of Orthopaedics, Children’s Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China

    Yao Liu, Lun-Qing Zhu, Fu-Yong Zhang, Ya Liu, Yun-Fang Zhen & Tan-Tan Zhao

Authors
  1. Yao Liu
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  2. Lun-Qing Zhu
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  3. Fu-Yong Zhang
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  4. Ya Liu
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  5. Yun-Fang Zhen
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Contributions

The authors confirm contribution to the paper as follows: study conception and design: YL, L-QZ, F-YZ; data collection: YL, T-TZ; analysis and interpretation of results: YL, Y-FZ; draft manuscript preparation: YL, F-YZ, Y-FZ. All authors reviewed the results and approved the final version of the manuscript.

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Correspondence to Fu-Yong Zhang.

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The authors declare that they have no competing interests.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of Ethics Committee of the Children’s Hospital of Soochow University.

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Informed consent was obtained from all individual participants included in the study.

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Liu, Y., Zhu, LQ., Zhang, FY. et al. Open Reduction of Displaced Radial Neck Fractures in Children by Internal Fixation Techniques: Comparison of Percutaneous Kirschner Wiring and Elastic Stable Intramedullary Nailing. JOIO 56, 1192–1198 (2022). https://doi.org/10.1007/s43465-022-00631-6

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  • DOI: https://doi.org/10.1007/s43465-022-00631-6

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