Percutaneous leverage reduction with two Kirschner wires combined with the Métaizeau technique versus open reduction plus internal fixation with a single Kirschner-wire for treating Judet IV radial neck fractures in children

• Published in: Journal of international medical research 2019-11, Vol.47 (11), p.5497-5507
• Main Authors: Du, Xiangping, Yu, Lirong, Xiong, Zhigang, Chen, Gan, Zou, Jun, Wu, Xinle, Xiong, Bin, Wang, Baoli
• Format: Article
• Language: English
• Subjects: Adolescent; Bone Wires - statistics & numerical data; Child; Clinical Research Reports; Elbow; Female; Follow-Up Studies; Fracture Fixation, Internal - methods; Fracture Fixation, Intramedullary - methods; Fractures; Humans; Male; Patients; Pediatrics; Prognosis; Radius Fractures - surgery; Surgical techniques; Wire
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/0300060519825990

Objective To compare the clinical effectiveness of a novel approach, percutaneous leverage reduction using two Kirschner-wires (k-wires) combined with the Métaizeau technique, versus open reduction plus internal fixation with k-wire for the treatment of Judet IV radial neck fractures in children. Methods Thirty-four patients with Judet IV radial neck fractures were treated either with percutaneous leverage reduction using two k-wires and the Métaizeau technique (n = 16) or open reduction plus internal fixation with k-wire (n = 18). Patient data including sex, age, time from trauma to surgery, fracture type, follow up, postoperative healing time, X-ray studies, elbow function, and complications were collected. Results There were no significant differences in patient characteristics between the two treatment groups. In postoperative elbow function assessment, 93.8% of patients in the group that underwent the novel treatment approach had a score of excellent or good, compared with 83.3% of patients in the open reduction and internal fixation with k-wire group. Furthermore, no postoperative complications were reported in patients in the novel treatment group, compared with 5 patients in the open reduction and internal fixation with k-wire group. All patients in both groups were classified as excellent or good according to Métaizeau criteria in postoperative X-ray assessment. Conclusions Compared with the open reduction and internal fixation with k-wire approach, percutaneous leverage reduction using two k-wires combined with the Métaizeau technique can significantly increase the minimally invasive reduction rate, and represents an attractive strategy for the treatment of Judet IV radial neck fractures in children.