A Percutaneous Reduction Technique For Irreducible And Difficult Variant Of Pediatric Distal Radius And Ulna Fracture

Objective:The aim of this artical is to describe a novel percutaneous reduction technique for irreducible and difficult pediatric radius and ulna fractures in the distal forearm.Methods:May 2010-January 2012,the pecutaneous joystick technique was conducted in 48 children who sustained irreducible and difficult fractures of the end of forearm.The series comprised of 32 male and 16 female patients,most of them are 11 old,(the youngest is 7,and the eldest is 15).Among them,22 patients are 9 old.In the end of follow-up,the rang of the motion of the wrist and grip strength of the hand were assessed.Measurements were compared to those on the opposite side.Wrist function was assessed with Mayor Wrist Score.Appearance and patients satisfaction were assessed using the 10-cm visual analogue scale.A P-value <0.05 was considered statistically significant.Results:Bone healing was achieved in all patients(radius: mean 3.5 weeks,range,3-4 weeks;ulna,3.8 weeks,range,3-4 weeks),respectively.After an average follow-up period of 39 months(range,36-45 months),patients had an average wrist of motion of 74°(from 65°to 86°)in flexion and 64°(from 54°to 78°)in extension.The mean grip strength of the injured side was 33.7Kg(13.8Kg-47.6Kg).the mean Mayor Wrist Score was 97(range,85-100).including 44 excellent and 4 good results.The mean scores of appearance and patient satisfaction on the forearm were 9.7(range,9-10)and 9.8(from 8 to 10),respectively.No significant deference was found regarding the range of motion and grip strength(P<0.05).Conclusions:The percutaneous reduction technique is a safe and valuable procedure for irreducible and difficult pediatric fractures of distal radius and ulna.