Modified Kapandji technique in pediatric displaced distal radius
fractures: results in 195 patients
DOKPE
- Bassi, Cristina ORCID University of Fribourg
- Heimann, Alexander F. ORCID University of Fribourg
- Schwab , Joseph M. ORCID University of Fribourg
- Tannast, Moritz ORCID University of Fribourg
- Raabe, Ines University of Fribourg
- 2024
Published in:
- European Journal of Orthopaedic Surgery & Traumatology. - Springer. - 2024, vol. 34, p. 489-497
English
Purpose
The modifed Kapandji technique has been proposed for fracture reduction in pediatric displaced distal radius fractures (DDRFs), but evidence is sparse. The purpose of this study was to evaluate our outcomes and complications, critically and systematically, when performing the modifed Kapandji technique in pediatric DDRFs. Using this technique since 2011, we asked: (1) What is the quality of fracture reduction using this technique? (2) How stable is fracture alignment with this technique? (3) What are the postoperative complications and complication rates?
Methods
Retrospective observational study of 195 pediatric patients treated with the modifed Kapandji technique. Quality of fracture reduction, fxation type (intrafocal, combined, or extrafocal), and coronal/sagittal angulation were recorded at surgery and healing. Perioperative complications were graded. Patients were stratifed by fracture (metaphyseal or Salter–Harris) and fxation type, as well as age (≤6 years; 6 to 10 years;>10 years).
Results
Fracture reduction was ‘good’ to ‘anatomical’ in 85% of patients. ‘Anatomical’ fracture reduction was less frequent in metaphyseal fractures (21% vs. 51%; p<.001). Mean angulation change was higher in metaphyseal fractures in both the sagittal (p=.011) and coronal (p=.021) planes. Metaphyseal fractures showed a higher mean change in sagittal angulation during fracture healing for the ‘intrafocal’ group. We observed a 15% overall complication rate with 1% being modifed Sink Grade 3.
Conclusion
The modifed Kapandji technique for pediatric DDRFs is a safe and efective treatment option. Metaphyseal
fractures that do not involve the physis should be treated with extrafocal or combined wire fxation. Complications that
require additional surgical treatment are rare.
Level of evidence
Level of evidence IV
The modifed Kapandji technique has been proposed for fracture reduction in pediatric displaced distal radius fractures (DDRFs), but evidence is sparse. The purpose of this study was to evaluate our outcomes and complications, critically and systematically, when performing the modifed Kapandji technique in pediatric DDRFs. Using this technique since 2011, we asked: (1) What is the quality of fracture reduction using this technique? (2) How stable is fracture alignment with this technique? (3) What are the postoperative complications and complication rates?
Methods
Retrospective observational study of 195 pediatric patients treated with the modifed Kapandji technique. Quality of fracture reduction, fxation type (intrafocal, combined, or extrafocal), and coronal/sagittal angulation were recorded at surgery and healing. Perioperative complications were graded. Patients were stratifed by fracture (metaphyseal or Salter–Harris) and fxation type, as well as age (≤6 years; 6 to 10 years;>10 years).
Results
Fracture reduction was ‘good’ to ‘anatomical’ in 85% of patients. ‘Anatomical’ fracture reduction was less frequent in metaphyseal fractures (21% vs. 51%; p<.001). Mean angulation change was higher in metaphyseal fractures in both the sagittal (p=.011) and coronal (p=.021) planes. Metaphyseal fractures showed a higher mean change in sagittal angulation during fracture healing for the ‘intrafocal’ group. We observed a 15% overall complication rate with 1% being modifed Sink Grade 3.
Conclusion
The modifed Kapandji technique for pediatric DDRFs is a safe and efective treatment option. Metaphyseal
fractures that do not involve the physis should be treated with extrafocal or combined wire fxation. Complications that
require additional surgical treatment are rare.
Level of evidence
Level of evidence IV
- Faculty
- Faculté des sciences et de médecine
- Department
- Médecine 3ème année
- Language
-
- English
- Classification
- Pathology, clinical medicine
- License
- License undefined
- Open access status
- green
- Identifiers
- Persistent URL
- https://folia.unifr.ch/unifr/documents/327512
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