ANTEGRADE ELASTIC STABABLE INTRAMEDULARI NAILING IN TREATMENT OF DISTAL RADIUS DIAPHYSEAL METAPHYSEAL JUNCTION FRACTURES IN CHILDREN

Abstract

The fractures of distal radius diaphyseal metaphyseal junction (DRDMJ) are one of the most frequent fractures in the pediatric population. In most cases, treatment of the fractures of DRDMJ is conservative. The aim of this study was to evaluate the benefits of using a new minimally invasive approach of closed reduction and internal fixation using an antegrade surgical approach and elastic stable intramedullary nail in the treatment of distal radius diaphyseal metaphyseal junction fractures in the pediatric population and to analyze the safety and efficacy of antegrade elastic stable intramedullary nail (ESIN) fixation. This study included 30 cases treated in the period from 2019 to 2021, where the use of non-surgical treatment did not work in children with distal radius diaphyseal metaphyseal junction fractures. In the surgical treatment, we used one titanium nail (2 or 2.5 mm) to achieve a correct closed reduction and internal fixation. The fracture healing was achieved in about 6 to 12 weeks after the procedure. Patients were then followed for another 6 months. In the postoperative period, there was no significant loss of reduction and no secondary displacement, nail migration, loss of fixation, non-union, or refracture. The combination of the closed reduction technique and the antegrade ESIN fixation is commonly used for the treatment of completely dislocated fractures in children. With this method we achieved minimally invasive treatment, short immobilization period, growth plate was not involved in the treatment and good outcome was accomplished.