Background: Intramedullary nailing is the most preferred fixation method for diaphyseal radius and ulna fractures in the young age group. The aim of this study was to compare the dorsal and lateral entry points in the context of entry site-related complications, fracture union and functional results.
Methods: This retrospective comparative study included pediatric patients who underwent surgery for isolated diaphyseal radius or both bone forearm fractures with intramedullary nailing using Kirschner wire between January 2013 and January 2019. K-wire was introduced from the distal radius through dorsal entry Group A) in 19 patients and lateral entry (Group B) in 18 patients. The mean follow-up was 37 months. Complications were noted and functional outcomes were evaluated according to the CHOP criteria.
Results: All fractures were healed. The functional results were determined to be excellent for 30, fair for 4, and poor for 3 patients. The overall complication rate was 18.9%, including distal radius fracture, mild pain in the wrist, and minor loss in ROM. No statistically significant differences were determined between the groups in respect of functional results and complication rates.
Conclusion: Good functional results and similar complication rates can be obtained with both dorsal and lateral entry approaches. Stainless steel K-wire is an inexpensive intramedullary fixation implant option, which provides strong stabilization. Distal radius fracture is a newly reported complication for forearm intramedullary nailing. Leaving the implant out of the skin seems safe with the benefit of avoiding a further surgical intervention to extract the implant.
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http://dx.doi.org/10.1007/s43465-021-00384-8 | DOI Listing |
Cureus
November 2024
Trauma and Orthopaedics, Hull Royal Infirmary, Hull, GBR.
Introduction Paediatric forearm fractures are common, but isolated radial diaphyseal fractures are rare, representing a small subset. Unlike fractures involving both the radius and ulna, these fractures lack well-established management guidelines. The potential for alignment loss during treatment underscores the need for specific protocols.
View Article and Find Full Text PDFInjury
December 2024
Department of Orthopaedics, Larnaca General Hospital, State Health Services Organisation, Larnaca, Cyprus.
The purpose of this study was to establish typical dose values at orthopaedic operating rooms of the Larnaca General Hospital (LGH). Kerma area product (KAP), fluoroscopy time (FT) and cumulative air-kerma (K) measurements were collected for 821 patients who underwent common and reproducible trauma surgery over a five-year period, with three mobile C-arm systems; two equipped with an image-intensifier and one with a flat-panel detector. Dose indices were automatically extracted from radiation dose structured reports or DICOM meta-data files archived in the PACS, using custom-made software.
View Article and Find Full Text PDFJt Dis Relat Surg
January 2025
Dr. Abdurrahman Yurtaslan Ankara Onkoloji Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, 06200 Yenimahalle, Ankara, Türkiye.
Objectives: This study aimed to investigate the importance of the Dorr index in the preoperative evaluation of implant failure in patients who underwent proximal femoral nail (PFN).
Patients And Methods: This retrospective study examined 312 patients who underwent PFN for intertrochanteric fractures between January 2016 and January 2020. Patients with unstable fractures according to the AO/OTA (AO Foundation/Orthopaedic Trauma Association) classification, those over 65 years of age, with at least one year of regular follow-up, a tip-apex distance <25 mm, and a caput-collum-diaphyseal angle between 125° and 135°, were included.
Cureus
December 2024
Trauma and Orthopaedics, Royal Surrey NHS Foundation Trust, Guildford, GBR.
Bone healing is a complex, dynamic process involving a series of well-coordinated stages, influenced by both mechanical and biological factors. The skeletal system, composed of inorganic (36%), organic (36%), and water (28%) components by volume, plays a crucial role in maintaining structural integrity and mineral homeostasis. Bone is classified into two main types based on microstructure: lamellar and woven bone, with lamellar bone being stronger and more durable.
View Article and Find Full Text PDFCureus
November 2024
Orthopaedics, Virginia Commonwealth University School of Medicine, Richmond, USA.
Distal femoral anterior cortical perforation is a rare complication of intramedullary nailing for proximal femur fractures. Awareness and intraoperative preventive measures are key to minimizing the risk of this complication. We report a case of a patient who experienced an anterior cortical breach of the distal femur during routine antegrade nailing for an intertrochanteric fracture, which was attributed to a sclerotic lesion in the distal femur.
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