Repurposing Spinal Distractor to Reduce Pediatric Wrist Fractures

Area of Science:

• Orthopedic Surgery
• Pediatric Orthopedics
• Skeletal Trauma Management

Background:

• Jagged bone spikes in pediatric distal radius-ulna fractures complicate closed reduction.
• Alternative treatments include incomplete reduction or open reduction, carrying risks of infection and physeal injury.

Purpose of the Study:

• To describe a novel technique, Percutaneous Skeletal Traction Aided Reduction (P_STAR), for managing these challenging fractures.
• To provide an alternative to incomplete or open reduction, minimizing associated risks.

Main Methods:

• P_STAR involves placing distraction pins proximal and distal to the fracture site.
• A spinal distractor is used to achieve fracture reduction over the irregular geometry.
• Percutaneous K-wires are then inserted for fracture stabilization.

Main Results:

• P_STAR successfully achieved near anatomic alignment in 18 pediatric patients.
• No instances of nerve or tendon injury, infection, or refracture were reported.
• The technique effectively overcomes the physical barrier presented by jagged bone spikes.

Conclusions:

• P_STAR is a safe and effective technique for reducing pediatric distal radius-ulna fractures with complex geometry.
• It offers a viable alternative to open reduction, reducing complication risks.
• This method facilitates achieving satisfactory fracture alignment in pediatric skeletal trauma.