Oun Ahmed Mohamed, Aldhilan Mansour M, Abdel-Wanis Mohamed E
Department of Orthopedic, Ar Rass General Hospital, Ministry of Health, Ar Rass, Saudi Arabia.
Department of Orthopedic, Sohag Faculty of Medicine, Sohag, Egypt.
Am J Case Rep. 2025 Apr 22;26:e946876. doi: 10.12659/AJCR.946876.
BACKGROUND In modern limb fracture management, particularly in children, image-guided closed reduction and percutaneous fixation are commonly employed. However, for older, displaced fractures, achieving closed reduction may be challenging or even unfeasible, often necessitating open reduction, which carries a higher risk of complications. We utilized K wires to fragment the fibrous callus and facilitate callus fragmentation in 2 patients with old fractures. In both cases, successful fracture reduction was achieved using a closed technique, followed by percutaneous K wire fixation. CASE REPORT Patient 1 was a 10-year-old girl who presented 10 days after sustaining a fully displaced fracture of the left radial neck due to trauma. Closed reduction under general anesthesia was unsuccessful. We employed percutaneous K wires to fragment the fibrous callus at the fracture site, enabling successful reduction and subsequent fixation. Patient 2 was a 50-year-old woman who presented with a displaced fracture at the base of the proximal phalanx of the little finger, initially treated with closed reduction and cast immobilization. At a follow-up examination 2 weeks later, the fracture was found to be fully displaced. Attempts at closed reduction under ring block anesthesia were unsuccessful. A percutaneous K wire was utilized to fragment the fibrous callus, enabling successful reduction and fixation. CONCLUSIONS The technique of fibrous callus fragmentation and closed reduction, followed by percutaneous K wire fixation, offers an effective approach for managing neglected, displaced fractures of the radial neck and the proximal phalanx of the little finger. This method allows for closed reduction and internal fixation in these challenging peri-articular fracture locations.
背景 在现代肢体骨折治疗中，尤其是儿童骨折，图像引导下的闭合复位和经皮固定被广泛应用。然而，对于年龄较大、有移位的骨折，实现闭合复位可能具有挑战性甚至不可行，往往需要切开复位，而切开复位会带来更高的并发症风险。我们使用克氏针对2例陈旧性骨折患者的纤维性骨痂进行碎裂，以促进骨痂碎裂。在这两例中，均采用闭合技术成功实现骨折复位，随后进行经皮克氏针固定。病例报告 患者1为一名10岁女孩，因外伤导致左桡骨颈完全移位骨折10天后就诊。全身麻醉下的闭合复位未成功。我们采用经皮克氏针对骨折部位的纤维性骨痂进行碎裂，从而成功复位并随后固定。患者2为一名50岁女性，因小指近节指骨基底移位骨折就诊，最初采用闭合复位和石膏固定治疗。2周后的随访检查发现骨折完全移位。环状阻滞麻醉下的闭合复位尝试未成功。使用一根经皮克氏针使纤维性骨痂碎裂，从而成功复位并固定。结论 纤维性骨痂碎裂及闭合复位，随后经皮克氏针固定的技术，为处理被忽视的桡骨颈和小指近节指骨移位骨折提供了一种有效方法。该方法允许在这些具有挑战性的关节周围骨折部位进行闭合复位和内固定。
