Ugutmen Ender, Ozkan Korhan, Ozkan Feyza Unlu, Eceviz Engin, Altintas Faik, Unay Koray
Department of Orthopedics and Traumatology, Goztepe Research and Training Hospital, Istanbul, Turkey.
J Pediatr Orthop B. 2010 Jul;19(4):289-93. doi: 10.1097/bpb.0b013e32833918a0.
In radius neck fractures, reduction manipulations applied on the radial head with percutaneous K-wires may lead to epiphysis or physis damage. In this study, 16 cases were evaluated without using any percutaneous manipulations upon the displaced radius head. Rather, an Ender-pin-like, curve-tipped K-wire was inserted intramedullary (Metaizeau technique) after a certain amount of reduction by manual manipulation under fluoroscopic guidance. Complete reduction was obtained with wire rotations in 16 patients. A total of 16 patients with open growth plates with an average age of 8 years were enrolled within the scope of the study. Thirteen patients (81.25%) showed excellent clinical results, two patients (12.5%) showed good results, and one patient (6.25%) showed average results. None of the cases exhibited poor results. A single K-wire was used in nine cases, whereas two K-wires were used for fixation rigidity in seven cases with larger medullas. No sign of neurovascular deficit, synostosis, or infection was observed in any of the cases. In conclusion, the use of two wires in patients with larger medullas and emphasis on the importance of closed reduction, even without percutaneous K-wire manipulation, might lead to the development of a new treatment approach for pediatric patients with radial head fractures.
在桡骨头颈部骨折中,经皮克氏针应用于桡骨头的复位操作可能会导致骨骺或生长板损伤。在本研究中,对16例移位的桡骨头骨折患者未使用任何经皮操作进行评估。相反,在透视引导下通过手法复位一定程度后,经髓内插入一根类似伊氏针的、尖端弯曲的克氏针(梅塔佐技术)。通过旋转克氏针,16例患者均实现了完全复位。本研究纳入了16例平均年龄为8岁的开放性生长板患者。13例患者(81.25%)临床结果优秀,2例患者(12.5%)结果良好,1例患者(6.25%)结果一般。无一例结果不佳。9例使用单根克氏针,7例髓腔较大的患者使用两根克氏针以增强固定强度。所有病例均未观察到神经血管缺损、骨桥形成或感染迹象。总之,对于髓腔较大的患者使用两根克氏针,并强调闭合复位的重要性,即使不进行经皮克氏针操作,也可能会为小儿桡骨头骨折患者开发出一种新的治疗方法。