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Ishiguro technique percutaneous metallic bone needle closed reduction for Judet IV radial head fractures in children: A case report (CARE-compliant).
СтатьяКлинический случайНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Chen Wenke, Ma Yalong, Feng Lin, Zhang Chongfang, Sun Jinsong, Han Nuan
Аннотация
RATIONALE: Fractures of the radial head in children constitute 5% to 17% of all elbow fractures and 1% of all pediatric fractures. As intra-articular injuries they pose significant challenges due to the high risk of loose body formation and ischemic necrosis, which can lead to long-term joint dysfunction and reduced quality of life. Although advances have been made in pediatric orthopedic surgery, developing minimally invasive and effective treatment strategies remains a crucial research focus for optimizing functional recovery and reducing complications.
PATIENT CONCERNS: An 8-year-old female patient sustained a left upper limb injury during a school recreational activity, resulting in immediate pain and restricted movement. Physical examination revealed mild swelling and tenderness in the left elbow, with no obvious deformity, but limited range of motion in the elbow joint and forearm. Radial artery pulsations were palpable, and finger movement and sensation were normal, indicating intact neurovascular function.
DIAGNOSIS: Fracture of the left radial head.
INTERVENTIONS: Using the Ishiguro technique with two 1.5-cm metallic bone pins, stable reduction of the fracture fragments was achieved. After trimming the pin ends, they were left outside the skin for fixation. The elbow joint was immobilized at approximately 80° of flexion using a plaster splint. The patient remained hemodynamically stable during surgery and was stable postoperatively when transferred to the ward.
OUTCOMES: After 6 weeks of plaster immobilization, the metallic bone pins were removed, revealing good fracture healing.
LESSON: This case report demonstrates the successful application of the Ishiguro technique, traditionally used for treating swan-neck deformities caused by avulsion fractures of the distal phalanx base, in the closed reduction and stable internal fixation of a pediatric Judet IV radial head fracture. By repurposing this technique, we have expanded its clinical utility and provided a minimally invasive treatment option for complex pediatric radial head fractures. This approach may enhance functional recovery, reduce surgical trauma, and offer potential cost-effectiveness, holding positive implications for advancing treatment strategies in pediatric orthopedics.
PATIENT CONCERNS: An 8-year-old female patient sustained a left upper limb injury during a school recreational activity, resulting in immediate pain and restricted movement. Physical examination revealed mild swelling and tenderness in the left elbow, with no obvious deformity, but limited range of motion in the elbow joint and forearm. Radial artery pulsations were palpable, and finger movement and sensation were normal, indicating intact neurovascular function.
DIAGNOSIS: Fracture of the left radial head.
INTERVENTIONS: Using the Ishiguro technique with two 1.5-cm metallic bone pins, stable reduction of the fracture fragments was achieved. After trimming the pin ends, they were left outside the skin for fixation. The elbow joint was immobilized at approximately 80° of flexion using a plaster splint. The patient remained hemodynamically stable during surgery and was stable postoperatively when transferred to the ward.
OUTCOMES: After 6 weeks of plaster immobilization, the metallic bone pins were removed, revealing good fracture healing.
LESSON: This case report demonstrates the successful application of the Ishiguro technique, traditionally used for treating swan-neck deformities caused by avulsion fractures of the distal phalanx base, in the closed reduction and stable internal fixation of a pediatric Judet IV radial head fracture. By repurposing this technique, we have expanded its clinical utility and provided a minimally invasive treatment option for complex pediatric radial head fractures. This approach may enhance functional recovery, reduce surgical trauma, and offer potential cost-effectiveness, holding positive implications for advancing treatment strategies in pediatric orthopedics.