Closed Reduction and Percutaneous Pinning in Management of Epiphyseal Injury of Distal Radius in Children

Abstract

Background: The goals of management of a displaced epiphyseal fracture of distal radius are to recover full function in a cosmetically normal wrist and elbow and avoidance of complication. The commonly accepted treatment in children is fracture reduction and percutaneous pin fixation. Objectives: Study of the results of treatment of displaced epiphyseal fractures of distal radius in children by closed reduction and percutaneous fixation by K-wires. Materials and Methods: Twenty-five children were treated by this method. Most of them were displaced dorsal and the others were displaced volar according to the directional displacement. The cases were examined clinically and radiologically at first. Twenty cases were operated in the same day and five cases were delayed because of sever edema. Results: the results were assessed both functionally and cosmetically according to evaluation of elbow, wrist function, pronation and supination and residual deformity. The overall results obtained were satisfactory with treatment by closed reduction and percutaneous pinning. Conclusion: we suggest that children who initially have a completely displaced fracture of the distal radius should be manipulated under general anesthesia and recommend that percutaneous K-wire fixation be used to ensure stabilization and avoid redisplacement, even when a perfect closed reduction has been achieved.