Abstract
Introduction: The distal forearm is the most common fracture site in children. The stresses from a fall on the outstretched hand are prone to result on a physeal or metaphyseal fracture of the distal radius. Fortunately subsequent growth disturbance is unusual. Our aim is to report the advantages or disadvantages of the Kapandji method compared with the crossed pin fixation.
Materials and Methods: We reviewed 29 children brought to the operating room for reduction and percutaneous fixation of distal forearm fractures during the last 18 months. There were 23 boys and 6 girls aging between 4 and 15 years old. Fractures were classified in four general types: physeal, torus, greenstick and complete. Sixteen fractures were fixed using the Kapandji technique and 13 were fixed with crossed pins.
Results: All patients recovered full range of motion. None of the fractures required open reduction. Pinning using the Kapandji technique was easier and took about 50% less of the operating time. Nevertheless we found that there was no leading criteria to decide which were the fractures that would need pinning after reduction. There was an incidence of 10% of superficial infections that subsided after removal of the wires with no further complications in both methods.
Conclusions and Discussion: Radial collapse, loss of wrist motion, and distal radioulnar joint dysfunction, all common problems associated with distal radius fractures in the adult, are rarely seen after children’s distal radial fractures. Closed reduction is usually easy. Although the final results were the same comparing crossed pin fixation and the Kapandji method, the later proved to be easier and less time consuming in the operating room. For this reason we favour this type of fixation for the distal forearm fractures in children.
Correspondence should be addressed to Ms Larissa Welti, Scientific Secretary, EFORT Central Office, Technoparkstrasse 1, CH-8005 Zürich, Switzerland
