[Treatment of childhood unstable radius distal methaphysis fractures with closed reduction and percutaneous Kirschner wires].
OBJECTIVES: We evaluated the results of treatment with closed reduction and percutaneous Kirschner wires in childhood unstable radius distal methaphysis fractures. METHODS: Forty-four fractures of radius distal methaphysis of 43 children (33 boys, 10 girls; mean age 11.7 years; range 8.6 to 16 years) were treated with immediate closed reduction and percutaneous Kirschner wires. Fractures with more than 50% displacement were considered unstable. A satisfactory reduction was defined as the presence of 80% cortical contact on anteroposterior and lateral x-rays, an angulation of less than 20 degrees and 15 degrees at ages below and over 10 years, respectively, and the absence of malrotation. Clinically, the range of motion of the elbow and wrist, forearm rotation, and grip strength were measured and compared with those of the other side in the 12th postoperative week. A restriction of 10 degrees or more in relation to the other side was regarded as failure. Radiologic indications of failure in the postoperative sixth week were residual angulations of more than 15 degrees and 10 degrees at ages below and above 10 years, respectively, and malrotation. RESULTS: Forty-one patients (93.2%) achieved a successful outcome. Failure was encountered in three patients (6.8%). Two patients developed type 1 pin tract infection, which resolved with antibiotic therapy and wound care. Patients returned to their normal activities in a mean of 10 weeks. CONCLUSION: Closed reduction and the use of percutaneous Kirschner wires proved to be the choice of treatment in unstable radius distal methaphysis fractures in children.