J Korean Fract Soc.  2015 Oct;28(4):237-244. 10.12671/jkfs.2015.28.4.237.

Operative Treatment of Pediatric Distal Forearm Bothbone Fracture

• Lee SU
• Jeong C
• Park IJ
• Lee J
• Oh S
• Lee KH
• Jeon S

• KMID: 2070350
• DOI: http://doi.org/10.12671/jkfs.2015.28.4.237

Abstract

PURPOSE
Pediatric patients with distal forearm bothbone fractures of surgical indication were treated with the Kapandji reduction technique for radius and flexible intramedullary nail for ulna at our institution. The purpose of this study is to evaluate clinical and radiological results.
MATERIALS AND METHODS
From February 2012 to June 2014, we retrospectively evaluated 16 out of 18 cases with distal forearm bothbone fractures treated with the Kapandji reduction technique for radius and flexible intramedullary nail for ulna with at least 1-year follow-up. The average age at operation was 9.1 years (7-13 years).
RESULTS
Adequate reduction for both radius and ulna was achieved for all cases, and none of the cases showed re-displacement until the last follow-up. Mean 6.6 weeks lapsed until bony union was observed for the radius. For the ulna, the mean was 6.5 weeks. All patients gained full wrist range of motion at the last visit.
CONCLUSION
For pediatric distal forearm bothbone fractures, intrafocal Kapandji reduction and internal fixation with Kirschner wire for radius and reduction and internal fixation with a flexible intramedullary nail for ulna is the technique for handy reduction. Use of this technique can prevent re-displacement during the union process and achieve excellent clinical and radiologic results.

Keyword

Distal forearm bothbone fracture; Kapandji reduction technique; Flexible intramedullary nail

MeSH Terms

Follow-Up Studies
Forearm*
Humans
Radius
Range of Motion, Articular
Retrospective Studies
Ulna
Wrist

Figure

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  Fig. 1 (A) Pin-leverage technique to lever up the distal fragment of the radius. (B) Nancy nail™ (flexible intramedullary nail) is inserted toward distal fragment (arrow) to achieve reduction.

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  Fig. 2 Measurement of displacement (%). a: width of proximal segment, b: displaced distance.

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  Fig. 3 (A) Both distal radius and ulna fracture of an 11-year-old boy. (B) Immediate postoperative X-ray. (C) Eight months after surgery.

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