Modified retrograde K-wire intramedullary fixation for treating pediatric distal radius diaphyseal-metaphyseal junction fractures: a novel method and a retrospective study.

PURPOSE: This study aimed to introduce a novel method, the modified retrograde K-wire intramedullary fixation (KWIF-R), for the treatment of pediatric distal radius diaphyseal-metaphyseal junction (DRDMJ) fractures, and to verify its clinical efficacy by comparing it with the retrograde elastic stable intramedullary nailing (ESIN-R).

METHODS

The clinical data of 26 children with DRDMJ fractures admitted to our hospital from April 2023 to November 2024 were retrospectively analyzed. Among them, 15 cases were treated with KWIF-R (KWIF-R group), and 11 patients were treated with the ESIN-R(ESIN-R group). By reviewing the medical records and follow-up results,surgical time, intraoperative bleeding, fluoroscopy times, alignment rate, and angulation on radiography were compared between the two groups. Forearm rotation, wrist function, and complications were compared at the last follow-up.

RESULTS

Both groups had successful operations, and the fractures healed completely. In the comparison of mean age、causes, and from injury to  surgical time between the two groups, the difference was not statistically significant (P > 0.05). The surgical time and fluoroscopy times of KWIF-R were lower than ESIN-R, and the difference was statistically significant (P < 0.05). In addition, the KWIF-R with no incision. The postoperative alignment rate of KWIF-R and ESIN-R was all satisfied (P > 0.05). In addition, no complications such as tendon rupture, skin irritation, or premature epiphyseal closure occurred in both groups.

CONCLUSION

KWIF-R provides a novel method for the treatment of pediatric DRDMJ fractures with satisfactory recovery of upper extremity motor function, and, with shorter surgical time, no incision, and less radiation exposure than the classical ESIN-R. It is a noteworthy surgical method for the treatment of pediatric DRDMJ fractures.