Stable Elastic Nail Application with Poller K-wire for Pediatric Irreducible Distal Radius Metaphyseal-Diaphyseal Junction Fractures: A New Operative Technique

Abstract

Abstract Background Surgical treatment of irreducible distal radius diaphyseal- metaphyseal junction fractures involves difficulties as the fracture remains too proximal for K-wire fixation and too distal for the elastic stable intramedullary nail. Our study aims to present the clinical results of applying an elastic stable intramedullary nail with a poller K-wire to achieve both reduction and stable fixation. Patients and Methods A retrospective analysis was performed on 26 patients who underwent ESIN with a poller K-wire for distal radius diaphyseal-metaphyseal region fracture. Reduction parameters such as residual angulation and alignment were evaluated on postoperative follow-up radiographs. Changes in angular and alignment parameters on follow-up radiographs were recorded. Wrist and forearm functions at the last follow-up were evaluated. Result There were 17 male and nine female patients with an average age of 10.9. The residual angulation in sagittal and coronal planes on immediate postoperative radiographs was 3° and 4°, respectively. The mean translation rate on immediate postoperative radiographs was 5% and 6% in the sagittal and coronal planes, respectively. No change was observed in translation rates in the last follow-ups, with an average of 1° of change in the coronal plane and 2° in the sagittal plane. No tendon injury or neurovascular injury was observed in any of the patients. Conclusion In the surgical treatment of pediatric distal radius diaphyseal metaphyseal junctional fractures, applying elastic stable intramedullary nailing with poller K-wire is an effective, safe, and novel method for achieving reduction and stable fixation.