Treatment Outcomes of Distal Forearm Metaphyseal Fractures in Children: A Comparison of Conservative and Surgical Approaches

Abstract

Background: Fractures metaphyseal zones distal department bones forearms occupy leading place in the structure children's injuries . Despite on high remodeling ability bone tissues in children , choice between conservative reposition and surgery fixation with knitting needles Kirchner remains a subject in scientific discussions.
Objectives: Conduct comparative analysis clinical, functional and radiological results conservative and surgical treatment metaphyseal fractures distal department forearms in children .
Patients and methods : 186 children aged from 6 to 14 years old with closed metaphyseal fractures bones forearms with displacement . In the first group 98 patients were included , who completed closed reposition with plaster cast immobilization . Second group comprised 88 children , who was carried out closed reposition with percutaneous fixation Kirschner wires . Assessment results conducted after 6 and 12 months By Mayo scale and data control radiography . Comparison categorical variables performed with the help of χ2, continuous - using Student's t-test.
Results : Anatomical recovery axes bones at primary repositions achieved in 89.8% of patients first group and 97.7% of the second groups (p = 0.031). In the group conservative treatment secondary bias fragments It was noted in 14.3% of patients that demanded repeated manipulations , then like in a group surgical treatment given indicator amounted to 2.3% (p = 0.004). After 12 months excellent and good functional results By according to the Mayo scale, it was recorded in 91.8% of children after conservative treatment and in 95.5% after surgical (p = 0.312). Infectious complications in the area conducting knitting needles observed in 4.5% of patients second groups.
Conclusions : Conservative reposition remains effective method treatment , however fixation with knitting needles Kirchner significantly reduces risk secondary displacements fragments and provides the best anatomical stability at expressed instability fracture .

Keywords :  
Fractures Forearms in Children ; Metaphyseal Fracture ; Spokes Kirchner ; Conservative Treatment ; Reposition Fragments