Abstract

FERREYRA, Andrés et al. Fracturas metafiso-diafisarias de radio distal en adolescentes: estudio comparativo entre fijación percutánea con clavijas y clavos elásticos de titanio. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2022, vol.87, n.3, pp.341-348. ISSN 1852-7434.  http://dx.doi.org/https://doi.org/10.15417/issn.1852-7434.2022.87.3.1458.

Objective: To compare results and complications of closed reduction percutaneous pinning (CRPP) versus dorsal entry elastic intramedullary nails (ESIN). Materials and Methods: Radiographs were evaluated to determine angular deformities at the time of radiographic union. Complications were graded with a modification of the Clavien-Dindo classification. Results: The CRPP group consisted of 17 patients (Group A) whereas the ESIN group consisted of 19 patients (Group B). The average age of the patient cohort was 12.5±1.6 years. The average follow-up was 27.6±16.6 months. The demographic data revealed no differences between groups (p> 0.05). Patients treated with ESIN required a shorter immobilization time (2.8±1.8 versus 5.9±1.3 weeks, p 0.00029). One patient in each group presented an angulation >10° at the time of consolidation. The complication rate was higher in group A (18% versus 5.3%, p 0.27). According to the Clavien-Dindo classification, group A presented 2 type II (infection and granuloma), and 2 type III complications (loss of reduction). Group B presented one type I complication (implant prominence). Sixteen patients in group B underwent a second procedure for hardware removal. Two patients (11.8%) in group A required revision due to loss of reduction. Conclusions: Both techniques are effective in stabilizing metaphyseal-diaphyseal fractures of the distal radius in the adolescent population. ESIN has the advantage of requiring a shorter immobilization time and fewer complications but needs a second surgery for implant removal. CRPP does not require anesthesia for implant removal, although it requires a longer postoperative immobilization, and has a higher complication rate.

Keywords : Distal radius fractures; adolescents; treatment; elastic intramedullary nails; percutaneous pinning.

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