Clinical Outcomes of Minimally Invasive Fixation with Pre‐Bent Elastic Stable Intramedullary Nails for the Treatment of Distal Radius Metaphyseal Diaphysis Junction Fractures in Children
Objective Although mini‐plate fixation is an attractive treatment option for distal radius metaphyseal diaphysis junction (DRMDJ) fractures in children, the benefits of minimally invasive fixation (MIF) with pre‐bent elastic stable intramedullary nails (MIF) remain underexplored. Therefore, this stu...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-12-01
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| Series: | Orthopaedic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/os.13919 |
| _version_ | 1797405570808938496 |
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| author | Limeng Yang Shuqin Wang Jindi Xu Changzong Deng Kai Wang Qing Li Hua Zhou Hongfeng Ruan Wei Zhuang |
| author_facet | Limeng Yang Shuqin Wang Jindi Xu Changzong Deng Kai Wang Qing Li Hua Zhou Hongfeng Ruan Wei Zhuang |
| author_sort | Limeng Yang |
| collection | DOAJ |
| description | Objective Although mini‐plate fixation is an attractive treatment option for distal radius metaphyseal diaphysis junction (DRMDJ) fractures in children, the benefits of minimally invasive fixation (MIF) with pre‐bent elastic stable intramedullary nails (MIF) remain underexplored. Therefore, this study aimed to evaluate the clinical efficacy of MIF administration in children with DRMDJ fractures. Methods This retrospective study enrolled 40 patients with DRMDJ fractures who underwent MIF or mini‐plate fixation from January 2016 to January 2021. Radiographic parameters, such as palmar inclination and ulnar deflection angle, were examined postoperatively to assess the anatomical reduction of the wrist joint. Clinical outcomes, including the range of wrist flexion and back extension, were examined to analyze the recovery of the wrist range of motion. Additionally, the Gartland–Werley scoring system was used to assess the recovery status of wrist function and healing condition. The student t‐test and χ2 test were used to compare differences among groups. Results All included patients successfully underwent the operation and were followed up for 12–24 months. Patients in the MIF group had a smaller surgical incision length (0.49 ± 0.06 cm) compared to those in the mini‐plate fixation group (4.41 ± 0.73 cm) (t = 22.438, p = 0.000). Palmar inclination and ulnar deflection were within the normal range in patients of both groups, and the fractures were successfully anatomically reduced. Moreover, wrist flexion and back extension in the MIF group and mini‐plate group were (72.50° ± 0.64° vs. 70.18° ± 0.56°) and (59.55° ± 1.75° vs. 60.04° ± 1.37°), and differences were statistically significant (t = 2.708, p = 0.010 and t = 0.885, p = 0.382, respectively). Furthermore, MIF treatment resulted in a higher proportion of excellent Gartland–Werley scores (94.44%) than mini‐plate fixation (86.36%) (p = 0.390). In addition, one case in the mini‐plate fixation group experienced re‐fracture following the removal of the internal fixation, and the fracture healed after reduction and cast fixation. All patients achieved satisfactory bone healing without other complications. Conclusion Compared with mini‐plate fixation, MIF has the advantages of small incision length, superior range of motion of thr wrist joint, and better maintenance of the physiological radian, providing a promising approach for clinical and surgical treatment of DRMDJ fractures. |
| first_indexed | 2024-03-09T03:11:55Z |
| format | Article |
| id | doaj.art-6d946246d2c34de88f4430c0b08c4b0f |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-03-09T03:11:55Z |
| publishDate | 2023-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj.art-6d946246d2c34de88f4430c0b08c4b0f2023-12-04T02:35:48ZengWileyOrthopaedic Surgery1757-78531757-78612023-12-0115123223323010.1111/os.13919Clinical Outcomes of Minimally Invasive Fixation with Pre‐Bent Elastic Stable Intramedullary Nails for the Treatment of Distal Radius Metaphyseal Diaphysis Junction Fractures in ChildrenLimeng Yang0Shuqin Wang1Jindi Xu2Changzong Deng3Kai Wang4Qing Li5Hua Zhou6Hongfeng Ruan7Wei Zhuang8Research Institute of Orthopaedics The Affiliated JiangNan Hospital of Zhejiang Chinese Medical University Hangzhou ChinaResearch Institute of Orthopaedics The Affiliated JiangNan Hospital of Zhejiang Chinese Medical University Hangzhou ChinaResearch Institute of Orthopaedics The Affiliated JiangNan Hospital of Zhejiang Chinese Medical University Hangzhou ChinaResearch Institute of Orthopaedics The Affiliated JiangNan Hospital of Zhejiang Chinese Medical University Hangzhou ChinaResearch Institute of Orthopaedics The Affiliated JiangNan Hospital of Zhejiang Chinese Medical University Hangzhou ChinaResearch Institute of Orthopaedics The Affiliated JiangNan Hospital of Zhejiang Chinese Medical University Hangzhou ChinaResearch Institute of Orthopaedics The Affiliated JiangNan Hospital of Zhejiang Chinese Medical University Hangzhou ChinaInstitute of Orthopaedics and Traumatology The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine) Hangzhou ChinaResearch Institute of Orthopaedics The Affiliated JiangNan Hospital of Zhejiang Chinese Medical University Hangzhou ChinaObjective Although mini‐plate fixation is an attractive treatment option for distal radius metaphyseal diaphysis junction (DRMDJ) fractures in children, the benefits of minimally invasive fixation (MIF) with pre‐bent elastic stable intramedullary nails (MIF) remain underexplored. Therefore, this study aimed to evaluate the clinical efficacy of MIF administration in children with DRMDJ fractures. Methods This retrospective study enrolled 40 patients with DRMDJ fractures who underwent MIF or mini‐plate fixation from January 2016 to January 2021. Radiographic parameters, such as palmar inclination and ulnar deflection angle, were examined postoperatively to assess the anatomical reduction of the wrist joint. Clinical outcomes, including the range of wrist flexion and back extension, were examined to analyze the recovery of the wrist range of motion. Additionally, the Gartland–Werley scoring system was used to assess the recovery status of wrist function and healing condition. The student t‐test and χ2 test were used to compare differences among groups. Results All included patients successfully underwent the operation and were followed up for 12–24 months. Patients in the MIF group had a smaller surgical incision length (0.49 ± 0.06 cm) compared to those in the mini‐plate fixation group (4.41 ± 0.73 cm) (t = 22.438, p = 0.000). Palmar inclination and ulnar deflection were within the normal range in patients of both groups, and the fractures were successfully anatomically reduced. Moreover, wrist flexion and back extension in the MIF group and mini‐plate group were (72.50° ± 0.64° vs. 70.18° ± 0.56°) and (59.55° ± 1.75° vs. 60.04° ± 1.37°), and differences were statistically significant (t = 2.708, p = 0.010 and t = 0.885, p = 0.382, respectively). Furthermore, MIF treatment resulted in a higher proportion of excellent Gartland–Werley scores (94.44%) than mini‐plate fixation (86.36%) (p = 0.390). In addition, one case in the mini‐plate fixation group experienced re‐fracture following the removal of the internal fixation, and the fracture healed after reduction and cast fixation. All patients achieved satisfactory bone healing without other complications. Conclusion Compared with mini‐plate fixation, MIF has the advantages of small incision length, superior range of motion of thr wrist joint, and better maintenance of the physiological radian, providing a promising approach for clinical and surgical treatment of DRMDJ fractures.https://doi.org/10.1111/os.13919Clinical outcomeDistal radius metaphyseal diaphysis junctionMinimally invasive fixationMini‐plate fixationPre‐bent elastic stable intramedullary nail |
| spellingShingle | Limeng Yang Shuqin Wang Jindi Xu Changzong Deng Kai Wang Qing Li Hua Zhou Hongfeng Ruan Wei Zhuang Clinical Outcomes of Minimally Invasive Fixation with Pre‐Bent Elastic Stable Intramedullary Nails for the Treatment of Distal Radius Metaphyseal Diaphysis Junction Fractures in Children Orthopaedic Surgery Clinical outcome Distal radius metaphyseal diaphysis junction Minimally invasive fixation Mini‐plate fixation Pre‐bent elastic stable intramedullary nail |
| title | Clinical Outcomes of Minimally Invasive Fixation with Pre‐Bent Elastic Stable Intramedullary Nails for the Treatment of Distal Radius Metaphyseal Diaphysis Junction Fractures in Children |
| title_full | Clinical Outcomes of Minimally Invasive Fixation with Pre‐Bent Elastic Stable Intramedullary Nails for the Treatment of Distal Radius Metaphyseal Diaphysis Junction Fractures in Children |
| title_fullStr | Clinical Outcomes of Minimally Invasive Fixation with Pre‐Bent Elastic Stable Intramedullary Nails for the Treatment of Distal Radius Metaphyseal Diaphysis Junction Fractures in Children |
| title_full_unstemmed | Clinical Outcomes of Minimally Invasive Fixation with Pre‐Bent Elastic Stable Intramedullary Nails for the Treatment of Distal Radius Metaphyseal Diaphysis Junction Fractures in Children |
| title_short | Clinical Outcomes of Minimally Invasive Fixation with Pre‐Bent Elastic Stable Intramedullary Nails for the Treatment of Distal Radius Metaphyseal Diaphysis Junction Fractures in Children |
| title_sort | clinical outcomes of minimally invasive fixation with pre bent elastic stable intramedullary nails for the treatment of distal radius metaphyseal diaphysis junction fractures in children |
| topic | Clinical outcome Distal radius metaphyseal diaphysis junction Minimally invasive fixation Mini‐plate fixation Pre‐bent elastic stable intramedullary nail |
| url | https://doi.org/10.1111/os.13919 |
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