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Analysis of the risk of a secondary displacement in conservati- vely treated paediatric distal radius metaphyseal fractures. A multicentric study.
Persiani, P; Martini, L; Calogero, V; Giannini, E; Speziale Varsamis, T; Mazza, O; Crostelli, M; Mascello, D; De Meo, D; Villani, C.
Afiliación
  • Persiani P; Department of Anatomical, Histological, Forensic Medicine and Musculoskeletal System Sciences, Sapienza University of Rome, Italy.
  • Martini L; Department of Anatomical, Histological, Forensic Medicine and Musculoskeletal System Sciences, Sapienza University of Rome, Italy.
  • Calogero V; Department of Anatomical, Histological, Forensic Medicine and Musculoskeletal System Sciences, Sapienza University of Rome, Italy.
  • Giannini E; Department of Anatomical, Histological, Forensic Medicine and Musculoskeletal System Sciences, Sapienza University of Rome, Italy.
  • Speziale Varsamis T; Department of Anatomical, Histological, Forensic Medicine and Musculoskeletal System Sciences, Sapienza University of Rome, Italy.
  • Mazza O; IRCCS Bambino Gesù Paediatric Hospital, Rome, Italy.
  • Crostelli M; IRCCS Bambino Gesù Paediatric Hospital, Rome, Italy.
  • Mascello D; IRCCS Bambino Gesù Paediatric Hospital, Palidoro, Italy.
  • De Meo D; Department of Anatomical, Histological, Forensic Medicine and Musculoskeletal System Sciences, Sapienza University of Rome, Italy.
  • Villani C; Department of Anatomical, Histological, Forensic Medicine and Musculoskeletal System Sciences, Sapienza University of Rome, Italy.
Clin Ter ; 173(1): 84-87, 2022 Feb 07.
Article en En | MEDLINE | ID: mdl-35147652
OBJECTIVES: Distal radius fractures represent one of the most fre-quent injuries in children. The treatment of choice is a closed reduction followed by immobilisation in plaster cast; the immediate recourse to osteosynthesis with Kirschner wires is only reserved for certain cases. The displacement rate reported in the literature is 21-39%. The aim of this study is to retrospectively evaluate the risk factors for a secondary displacement of metaphyseal radius fractures in a paediatric population treated in three different centres. MATERIALS AND METHODS: The initial treatment for all 360 patients examined was a closed reduction under general anaesthesia and im-mobilisation in an above elbow cast for 4 weeks. The pre-operative displacement, residual post-reduction displacement and possible di-splacement at 7 and 14 days of follow-up were all assessed clinically and radiographically. RESULTS: A loss of reduction was reported in 102 cases; 51 under-went an additional reduction procedure - some followed by osteo-synthesis - while in the remaining 51 cases, the loss of reduction was acceptable in relation to the expectation of remodelling. The most statistically significant variable for the occurrence of a secondary displacement is a severe primary displacement. The association with the ulna fracture is not significantly correlated. The quality of the plaster cast is important for maintaining the reduction. There are a few things to consider as indicators for a second procedure: age, time elapsed from moment of fracture, fracture site and the absence of an acceptable reduction. CONCLUSIONS: In our experience, a reduction followed by osteo-synthesis with Kirschner wires should be considered the treatment of choice in fractures with a high risk of secondary displacement, namely those with severe initial displacement or unsatisfactory reduction.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fracturas del Radio / Fracturas del Cúbito Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Child / Humans Idioma: En Revista: Clin Ter Año: 2022 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Italia
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fracturas del Radio / Fracturas del Cúbito Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Child / Humans Idioma: En Revista: Clin Ter Año: 2022 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Italia