Flexible intramedullary nailing versus Kirschner wire fixation in the treatment of paediatric radial neck fractures: a minimum 2-year follow-up study

IF 2.1 3区医学 Q2 ORTHOPEDICS

Archives of Orthopaedic and Trauma Surgery Pub Date : 2025-09-16 DOI:10.1007/s00402-025-06066-6

Kun Jiang, Wenyu Feng, Lei Geng, Bufeng Zheng

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引用次数: 0

Abstract

Introduction

The aims of this study were to compare the clinical outcomes of flexible intramedullary nailing (FIN) and Kirschner wire (KW) fixation in the surgical treatment of paediatric radial neck fractures to provide evidence-based guidance for optimising therapeutic strategies.

Methods

In this retrospective comparative study, the cases of 68 paediatric patients with Judet III–IV radial neck fractures between February 2018 and March 2023 were analysed; 37 patients underwent FIN, and 31 KW. Comparative parameters included operative time, time to implant removal, complications, and functional recovery, which were evaluated using forearm rotation loss, the Mayo Elbow Performance Score (MEPS), and the Métaizeau radiographic classification.

Results

All patients were followed for a minimum of 24 months postoperatively. Baseline characteristics were comparable between the groups. No significant difference in operative time was observed between the two groups. The time to implant removal was significantly longer in the FIN group (262.05 ± 49.16 days) than in the KW group (32.06 ± 3.63 days; P < 0.05). Functional outcomes, as assessed by the MEPS, were significantly better in the FIN group, with 97.3% of patients achieving excellent or good results, compared to 83.9% in the KW group (P < 0.05). Additionally, the FIN group exhibited significantly less forearm rotation loss (6.03 ± 8.44° vs. 17.06 ± 19.04°, P < 0.05). Although complication rates were generally low, the KW group had a slightly higher incidence, primarily due to pin tract infections.

Conclusions

FIN fixation offers superior functional outcomes, less forearm rotation loss, and a lower risk of superficial infection compared to KW fixation for paediatric radial neck fractures. While KW allows for earlier implant removal, it is associated with a greater risk of infection. Therefore, FIN is recommended as the preferred surgical option in clinical practice.

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弹性髓内钉与克氏针固定治疗儿童桡骨颈骨折：至少2年随访研究

本研究的目的是比较柔性髓内钉（FIN）和克氏针（KW）固定在小儿桡骨颈骨折手术治疗中的临床效果，为优化治疗策略提供循证指导。方法回顾性比较分析2018年2月至2023年3月68例小儿桡骨颈骨折病例；37例患者接受FIN， 31例患者接受KW。比较参数包括手术时间、植入物取出时间、并发症和功能恢复，使用前臂旋转损失、梅奥肘关节功能评分（MEPS）和m taizeau放射学分类进行评估。结果所有患者术后随访至少24个月。两组间基线特征具有可比性。两组手术时间差异无统计学意义。FIN组种植体拔除时间（262.05±49.16 d）明显长于KW组（32.06±3.63 d; P < 0.05）。根据MEPS评估，FIN组的功能结局明显更好，97.3%的患者获得优异或良好的结果，而KW组为83.9% （P < 0.05）。此外，FIN组前臂旋转损失显著减少（6.03±8.44°vs. 17.06±19.04°，P < 0.05）。虽然并发症发生率普遍较低，但KW组的发生率略高，主要是由于针道感染。结论：与KW固定相比，fin固定治疗儿童桡骨颈骨折具有更好的功能效果，更少的前臂旋转丧失和更低的表面感染风险。虽然KW允许更早地移除种植体，但它与更大的感染风险相关。因此，在临床实践中，FIN被推荐为首选的手术选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Orthopaedic and Trauma Surgery 医学-外科

CiteScore

4.30

自引率

13.00%

发文量

424

审稿时长

2 months

期刊介绍： "Archives of Orthopaedic and Trauma Surgery" is a rich source of instruction and information for physicians in clinical practice and research in the extensive field of orthopaedics and traumatology. The journal publishes papers that deal with diseases and injuries of the musculoskeletal system from all fields and aspects of medicine. The journal is particularly interested in papers that satisfy the information needs of orthopaedic clinicians and practitioners. The journal places special emphasis on clinical relevance. "Archives of Orthopaedic and Trauma Surgery" is the official journal of the German Speaking Arthroscopy Association (AGA).