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Displaced paediatric distal radius fractures--when should we use percutaneous wires?
1Trauma & Orthopaedic Department, Birmingham Heartlands Hospital, United Kingdom. robert.jordan@doctors.org.uk
Purpose:
To establish the intra-operative radiographic parameters that predict the need for percutaneous wire fixation to prevent redisplacement following manipulation for displaced paediatric distal radius fractures.
Materials And Methods:
A retrospective study of 105 children, assessing pre-, intra- and post-operative radiographs. Optimal reduction was defined as less than 10% residual translation and less than 5° of angulation on anteroposterior and lateral radiographs. Redisplacement was defined as more than 20° angulation or 50% translation on either view.
Results:
No fracture that was optimally reduced redisplaced. 40% of fractures with suboptimal reduction redisplaced. Initial translation was significantly associated with redisplacement.
Conclusions:
If our criteria for optimal reduction are met, closed reduction and casting can be confidently employed. If not, percutaneous wires should be employed to avoid redisplacement, especially in cases with a high grade of initial translation.
