• Oper Orthop Traumatol · Oct 2008

    Clinical Trial

    [Osteosynthesis in proximal forearm fractures in children].

    • Peter P Schmittenbecher.
    • Kinderchirurgische Klinik, Klinikum Karlsruhe, Karlsruhe, Germany. peter.schmittenbecher@klinikum-karlsruhe.de
    • Oper Orthop Traumatol. 2008 Oct 1;20(4-5):321-33.

    ObjectiveClosed reduction and fixation of displaced proximal radial neck or ulnar fractures with elastic stable intramedullary nailing (ESIN); prevention of circulatory disturbances and functional deficits following open reduction.IndicationsProximal radial neck fractures > 45 degrees displacement (< 10 years of age) or > 20 degrees (> 10 years of age); proximal extraarticular ulnar fractures > 10 degrees malalignment; combination injuries (Monteggia fracture, Monteggia-equivalent injury).ContraindicationsMinimally displaced or undisplaced fractures.Surgical TechniqueRadius: distal implantation of the nail; touching and fixation of the proximal fragment with the tip of the nail, if need be following digital or percutaneous partial reduction (Kirschner wire); definitive reduction by torsion of the nail. Ulna: distal implantation of a prebent nail; the prebent curve is placed opposite to the malalignment.Postoperative ManagementFunctional treatment, no additive immobilization, no physical therapy.Results78-87% very good and good functional results.

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