Department of Orthopaedic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China (mainland).
Med Sci Monit. 2023 Jul 3;29:e939852. doi: 10.12659/MSM.939852.
BACKGROUND The treatment of distal radius diaphyseal metaphyseal junction (DMJ) fracture in children is a clinical problem; several treatments are available, but none are very effective. Therefore, this study aimed to report a novel method for treating this fracture using limited open reduction and transepiphyseal intramedullary fixation with Kirschner wire. MATERIAL AND METHODS From January 2018 to December 2019, a total of 15 children (13 boys and 2 girls) with distal radius DMJ fractures with a mean age of 10 years (range: 6-14 years) were included in the study. The operation time, incision length, and X-ray radiation exposure were precisely recorded. All children were followed up regularly. At the final follow-up, clinical outcomes were evaluated according to Price criteria, and complications were recorded. RESULTS The mean operation time of the 15 children was 21.4 min, and the mean incision length was 1.9 cm. The intraoperative X-ray was performed 3.7 times on average. The mean radiographic union of fracture was 4.7 weeks, and the mean time to remove the Kirschner wire was 4.8 weeks for radial instrumentation and 4.7 months for ulnar instrumentation. According to the Price grading evaluation system, clinical outcome was excellent in 14 cases and good in 1 case. Moreover, there were no major complications related to loss of reduction, malunion, nonunion, and physeal arrest of the distal radius. CONCLUSIONS Limited open reduction and transepiphyseal intramedullary fixation with Kirschner wire are effective for treating distal radius DMJ fracture in children, which has the advantages of simple surgical procedures, short operation time, small incision, and less radiation exposure, making it an excellent choice for treating this fracture.
儿童桡骨骨干骺端交界处（DMJ）骨折的治疗是一个临床问题；有几种治疗方法，但都不是很有效。因此，本研究旨在报告一种使用有限切开复位和经骺骨穿针内固定克氏针治疗这种骨折的新方法。
从 2018 年 1 月至 2019 年 12 月，共有 15 例儿童（13 名男孩和 2 名女孩）患有桡骨 DMJ 骨折，平均年龄为 10 岁（范围：6-14 岁）。精确记录手术时间、切口长度和 X 射线辐射暴露。所有儿童均定期随访。在最终随访时，根据 Price 标准评估临床结果，并记录并发症。
15 例儿童的平均手术时间为 21.4 分钟，平均切口长度为 1.9 厘米。术中 X 射线平均拍摄 3.7 次。骨折平均放射学愈合时间为 4.7 周，桡骨内固定取出克氏针的平均时间为 4.8 周，尺骨内固定取出克氏针的平均时间为 4.7 个月。根据 Price 分级评估系统，14 例临床结果为优，1 例为良。此外，没有与复位丢失、畸形愈合、不愈合和桡骨骨骺阻滞相关的重大并发症。
有限切开复位和经骺骨穿针内固定克氏针治疗儿童桡骨 DMJ 骨折有效，具有手术操作简单、手术时间短、切口小、辐射暴露少的优点，是治疗这种骨折的理想选择。
