Short intramedullary wiring for displaced metaphyseal fractures of the radius in children


Published online: Apr 27 2013

Mario HERRERA-PEREZ, Heriberto ALVAREZ-ALCOVER, Jose Luis PAIS-BRITO

From the University Hospitals of Tenerife (Canary Isles), Spain

Abstract

There is still debate about the proper treatment of completely displaced metaphyseal fractures of the distal radius in children. Although historically these fractures were treated by closed reduction and casting, some authors have reported that up to 25% of these injuries re-displaced early in the cast despite good initial reduction. Since 2000 we have used closed reduction and percutaneous stabilisation with a short intramedullary wire, using a percutaneous technique, in children with completely displaced metaphyseal fractures of the distal radius. We retrospectively analysed the records of 100 children who were treated in our departments during a six-year period (2000-2005). Of these, 45 had early re-displacement of their fractures after an initial conservative treatment. Our results suggest that closed reduction and short intramedullary wiring of these injuries allows adequate stabilization, maintains the alignment in the cast, reduces the need for follow-up radiographs, with a low rate of infections and complications, while healing occurs.