Istituto Di Clinica Ortopedica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Via Giuseppe Moscati 31, 00168, Roma, Italia.
Istituto Di Clinica Ortopedica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italia.
Eur J Orthop Surg Traumatol. 2020 Oct;30(7):1243-1250. doi: 10.1007/s00590-020-02698-z. Epub 2020 May 13.
Closed reduction and internal fixation are a widespread surgical treatment for pediatrics displaced extraphyseal distal radius fractures. Post-surgical cast immobilization is usually needed. Epibloc system (ES) is a device used to fix Colles fractures in adults, not requiring post-surgical immobilization. The aim of the study is to investigate the effectiveness of ES in a pediatric population suffering from displaced extraphyseal distal radius fractures.
We retrospectively analyzed 52 patients (age 8-12 years) who underwent CRIF. Patients were divided into two groups. Group A (25 patients): ES osteosynthesis. Group B (27 patients): K-wires and short arm cast osteosynthesis. The primary outcome is the maintenance of reduction in radiographs (displacement on frontal and lateral view). The secondary outcome is the reaching of the complete active range of motion recovery (compared with the contralateral side) and the time needed to obtain it. The need of further additional treatment (physiotherapy) and the presence of complication were also assessed.
Reduction was equally maintained in both groups (p > 0.05). Physiotherapy was mandatory for 11 patients in group B; only for 3 patients in group A, the difference was statistically significant (p = 0.03) according to Fisher test. Otherwise, the difference was not statistically significant regarding complications. (p > 0.05). At the last follow-up, complete functional recovery was reached in all patients.
Functional recovery is faster, and postoperative physiotherapy is rarely required with ES. This device allows us to go beyond the traditional concept of mandatory postoperative immobilization after pediatric wrist fractures surgery.
闭合复位内固定是治疗儿童骺外远端桡骨骨折的一种广泛应用的手术治疗方法。术后通常需要石膏固定。Epibloc 系统（ES）是一种用于固定成人科雷氏骨折的装置，不需要术后固定。本研究旨在探讨 ES 在患有骺外远端桡骨骨折的儿科人群中的疗效。
我们回顾性分析了 52 名（8-12 岁）接受 CRIF 的患者。患者分为两组。A 组（25 例）：ES 骨合成。B 组（27 例）：克氏针和短臂石膏骨合成。主要结果是 X 线片上的复位保持（正位和侧位的移位）。次要结果是完全主动运动范围的恢复（与对侧相比）和达到完全主动运动范围所需的时间。还评估了进一步的额外治疗（物理治疗）的需要和并发症的发生。
两组的复位均保持良好（p>0.05）。B 组 11 例患者需要进行物理治疗；A 组仅 3 例患者需要进行物理治疗，Fisher 检验差异具有统计学意义（p=0.03）。否则，并发症方面的差异无统计学意义（p>0.05）。末次随访时，所有患者均达到完全功能恢复。
ES 可更快恢复功能，术后很少需要进行物理治疗。该装置使我们能够超越儿童腕骨骨折手术后传统的强制性术后固定概念。
