Clinical outcomes of closed, displaced phalangeal neck fractures in children with different types of kirschner wire fixation: A retrospective observational study

ObjectivesInappropriate treatment of Closed displaced phalangeal neck fractures (CDPNF) in children usually leads to poor outcomes.This study was to evaluate the clinical outcomes of closed/open reduction, age, and different types of fracture and Kirschner wire (K-wire) fixation in the treatment of...

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Main Authors: Chunxing Wu, Jun Song, Bo Ning, Yueqiang Mo, Dahui Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-02-01
Series:Frontiers in Pediatrics
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fped.2023.1039415/full
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author Chunxing Wu
Jun Song
Bo Ning
Yueqiang Mo
Dahui Wang
author_facet Chunxing Wu
Jun Song
Bo Ning
Yueqiang Mo
Dahui Wang
author_sort Chunxing Wu
collection DOAJ
description ObjectivesInappropriate treatment of Closed displaced phalangeal neck fractures (CDPNF) in children usually leads to poor outcomes.This study was to evaluate the clinical outcomes of closed/open reduction, age, and different types of fracture and Kirschner wire (K-wire) fixation in the treatment of CDPNF.Materials and methodsParticipants: Sixty patients (male, 46 and female,14; right-handed, 35 and left-handed, 25; mean age, 7.9-years-old [range, 1.0–14.5 years]) who had CDPNF were included. Preoperative x-rays showed that the fractures were displaced and exhibited obvious deformities. Interventions: First, reduction (four cases of open reduction and 56 cases of closed reduction) was performed followed by percutaneous K-wire fixation (cross fixation, 24 cases; longitudinal and slanting fixation, 17 cases; homolateral fixation, four cases; and single longitudinal fixation, 15 cases,) and immobilized by cast. x-ray examination following removal of the K-wires showed that the fractures were healed; the criteria for fracture healing were callus formation and the absence of fracture lines. Clinical outcome and radiographs between groups were compared.ResultsAccording to the visual analogue scale, the pain scores were excellent. According to the Al-Qattan Grade system(AGS),all the patients presented with closed, type II phalangeal neck fractures,the results were excellent in 36 cases (36/60, 60%), good in 15 cases (15/60, 25%), fair in 5 cases (5/60, 8.3%) and poor in 4 cases (4/60, 6.7%). There were significant differences in different fracture type groups (P = 0.013*), operation age groups (P = 0.025*) and open/closed reduction groups (P = 0.042*). There was no significant difference in K-wire fixation type groups (P > 0.05).ConclusionsPatients with open reduction, the more serious fracture type, the older at the operation, were more likely to have poor AGS result. Different K-wire fixation types for CDPNF in children had the same satisfactory results.
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spelling doaj.art-4393230b08284eee8300027ab7ba4e3b2023-02-24T17:39:36ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-02-011110.3389/fped.2023.10394151039415Clinical outcomes of closed, displaced phalangeal neck fractures in children with different types of kirschner wire fixation: A retrospective observational studyChunxing WuJun SongBo NingYueqiang MoDahui WangObjectivesInappropriate treatment of Closed displaced phalangeal neck fractures (CDPNF) in children usually leads to poor outcomes.This study was to evaluate the clinical outcomes of closed/open reduction, age, and different types of fracture and Kirschner wire (K-wire) fixation in the treatment of CDPNF.Materials and methodsParticipants: Sixty patients (male, 46 and female,14; right-handed, 35 and left-handed, 25; mean age, 7.9-years-old [range, 1.0–14.5 years]) who had CDPNF were included. Preoperative x-rays showed that the fractures were displaced and exhibited obvious deformities. Interventions: First, reduction (four cases of open reduction and 56 cases of closed reduction) was performed followed by percutaneous K-wire fixation (cross fixation, 24 cases; longitudinal and slanting fixation, 17 cases; homolateral fixation, four cases; and single longitudinal fixation, 15 cases,) and immobilized by cast. x-ray examination following removal of the K-wires showed that the fractures were healed; the criteria for fracture healing were callus formation and the absence of fracture lines. Clinical outcome and radiographs between groups were compared.ResultsAccording to the visual analogue scale, the pain scores were excellent. According to the Al-Qattan Grade system(AGS),all the patients presented with closed, type II phalangeal neck fractures,the results were excellent in 36 cases (36/60, 60%), good in 15 cases (15/60, 25%), fair in 5 cases (5/60, 8.3%) and poor in 4 cases (4/60, 6.7%). There were significant differences in different fracture type groups (P = 0.013*), operation age groups (P = 0.025*) and open/closed reduction groups (P = 0.042*). There was no significant difference in K-wire fixation type groups (P > 0.05).ConclusionsPatients with open reduction, the more serious fracture type, the older at the operation, were more likely to have poor AGS result. Different K-wire fixation types for CDPNF in children had the same satisfactory results.https://www.frontiersin.org/articles/10.3389/fped.2023.1039415/fullchildrenphalangeal neckfracturelongitudinal and slantingkirschner wire
spellingShingle Chunxing Wu
Jun Song
Bo Ning
Yueqiang Mo
Dahui Wang
Clinical outcomes of closed, displaced phalangeal neck fractures in children with different types of kirschner wire fixation: A retrospective observational study
Frontiers in Pediatrics
children
phalangeal neck
fracture
longitudinal and slanting
kirschner wire
title Clinical outcomes of closed, displaced phalangeal neck fractures in children with different types of kirschner wire fixation: A retrospective observational study
title_full Clinical outcomes of closed, displaced phalangeal neck fractures in children with different types of kirschner wire fixation: A retrospective observational study
title_fullStr Clinical outcomes of closed, displaced phalangeal neck fractures in children with different types of kirschner wire fixation: A retrospective observational study
title_full_unstemmed Clinical outcomes of closed, displaced phalangeal neck fractures in children with different types of kirschner wire fixation: A retrospective observational study
title_short Clinical outcomes of closed, displaced phalangeal neck fractures in children with different types of kirschner wire fixation: A retrospective observational study
title_sort clinical outcomes of closed displaced phalangeal neck fractures in children with different types of kirschner wire fixation a retrospective observational study
topic children
phalangeal neck
fracture
longitudinal and slanting
kirschner wire
url https://www.frontiersin.org/articles/10.3389/fped.2023.1039415/full
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