Treatment of paediatric unstable displaced distal radius fractures using Kapandji technique: a case series

The technique of intra-focal pinning described by Kapandji is seldom used in paediatric patients. We present our series of paediatric patients treated with Kapandji technique for unstable displaced distal radius fractures.

We retrospectively reviewed medical records and radiographs of a consecutive series of 56 paediatric patients who underwent closed reduction and fixation with Kapandji technique for unstable displaced metaphyseal and Salter Harris 2 distal radius fractures, from 2008 to March 2018. One or two percutaneous K-wires were inserted intra-focally without crossing the physis to lever out, reduce and stabilize the distal fragment. The arm was immobilized with an above-elbow cast, and radiographic controls were scheduled at 1, 4, 8 weeks, at least.

The mean age at the time of the trauma was 10.5 years. The K-wires were removed at a mean of 6.4 post-operative weeks. An above-elbow cast was used for the first 4 weeks, afterwards a below-elbow cast for 2 weeks and a short-arm brace until the full recovery of motion. The mean follow-up was 18 months (range 1.5-108 months). No pin-related complications were found. All fractures showed good healing, and the full function of the wrist was achieved in every case.

Kapandji pinning is a reliable technique in paediatric patients with unstable displaced distal radius fractures. It shows a lower complication rate compared to other techniques. For these reasons, we suggest implementing its use in clinical practice.