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Cast versus wire fixation in displaced distal radius fractures in children : outcomes at skeletal maturity

Introduction: Displacement following fracture reduction was a common complication during casting period in children previously treated for the distal radius fracture. Fracture stabilization with wire fixation was also used to maintain the reduction during fracture healing, but not without complic...

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Main Author: Halim, Syurahbil Abdul
Format: Thesis
Language:English
Published: 2019
Subjects:
R Medicine
Online Access:http://eprints.usm.my/51086/1/Dr.%20Syurahbil%20Abdul%20Halim-24%20pages.pdf
http://eprints.usm.my/51086/
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spelling my.usm.eprints.51086 http://eprints.usm.my/51086/ Cast versus wire fixation in displaced distal radius fractures in children : outcomes at skeletal maturity Halim, Syurahbil Abdul R Medicine Introduction: Displacement following fracture reduction was a common complication during casting period in children previously treated for the distal radius fracture. Fracture stabilization with wire fixation was also used to maintain the reduction during fracture healing, but not without complications. We evaluated the clinical and radiological outcomes at skeletal maturity of distal radius fractures in children previously treated either with cast alone or with wire fixation. Methodology: A retrospective study of 57 patients with both metaphyseal and physeal fractures of distal radius was conducted. Out of 30 patients with metaphyseal fractures, 19 were in cast group and 11 were in wire group. Nineteen out of 27 patients with physeal fractures were from cast group while eight were from wire group. All were evaluated clinically and radiologically at or after skeletal maturity at the mean follow up of 6.5 years (3.0 to 9.0 years). Results: In metaphysis group, patients treated with wire fixation had more restriction in wrist palmarflexion (p=0.04) only but in physis group, more restriction of motion was found in both dorsiflexion (p=0.04) and palmarflexion (p=0.01) when compared to contralateral wrist. In physis group, there was a statistically significant difference in radial inclination (p=0.01) and dorsal tilt (p=0.03) between cast and wire fixation. No radiological difference was found in metaphysis group. All patients were pain free except one (5.3%) in physis group who had only a mild pain. Grip strength showed no statistical difference in all groups. Complications of wire included radial and ulnar physeal arrests, pin site infection and numbness. Conclusions: Cast and wire fixation showed excellent and good outcomes at skeletal maturity in children with previous distal radius fracture involving both metaphysis and physis. Site of fracture and type of treatment subjected have no influence on the grip strength at skeletal maturity. 2019 Thesis NonPeerReviewed application/pdf en http://eprints.usm.my/51086/1/Dr.%20Syurahbil%20Abdul%20Halim-24%20pages.pdf Halim, Syurahbil Abdul (2019) Cast versus wire fixation in displaced distal radius fractures in children : outcomes at skeletal maturity. Masters thesis, Universiti Sains Malaysia.
institution Universiti Sains Malaysia
building Hamzah Sendut Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Sains Malaysia
content_source USM Institutional Repository
url_provider http://eprints.usm.my/
language English
topic R Medicine
spellingShingle R Medicine
Halim, Syurahbil Abdul
Cast versus wire fixation in displaced distal radius fractures in children : outcomes at skeletal maturity
description Introduction: Displacement following fracture reduction was a common complication during casting period in children previously treated for the distal radius fracture. Fracture stabilization with wire fixation was also used to maintain the reduction during fracture healing, but not without complications. We evaluated the clinical and radiological outcomes at skeletal maturity of distal radius fractures in children previously treated either with cast alone or with wire fixation. Methodology: A retrospective study of 57 patients with both metaphyseal and physeal fractures of distal radius was conducted. Out of 30 patients with metaphyseal fractures, 19 were in cast group and 11 were in wire group. Nineteen out of 27 patients with physeal fractures were from cast group while eight were from wire group. All were evaluated clinically and radiologically at or after skeletal maturity at the mean follow up of 6.5 years (3.0 to 9.0 years). Results: In metaphysis group, patients treated with wire fixation had more restriction in wrist palmarflexion (p=0.04) only but in physis group, more restriction of motion was found in both dorsiflexion (p=0.04) and palmarflexion (p=0.01) when compared to contralateral wrist. In physis group, there was a statistically significant difference in radial inclination (p=0.01) and dorsal tilt (p=0.03) between cast and wire fixation. No radiological difference was found in metaphysis group. All patients were pain free except one (5.3%) in physis group who had only a mild pain. Grip strength showed no statistical difference in all groups. Complications of wire included radial and ulnar physeal arrests, pin site infection and numbness. Conclusions: Cast and wire fixation showed excellent and good outcomes at skeletal maturity in children with previous distal radius fracture involving both metaphysis and physis. Site of fracture and type of treatment subjected have no influence on the grip strength at skeletal maturity.
format Thesis
author Halim, Syurahbil Abdul
author_facet Halim, Syurahbil Abdul
author_sort Halim, Syurahbil Abdul
title Cast versus wire fixation in displaced distal radius fractures in children : outcomes at skeletal maturity
title_short Cast versus wire fixation in displaced distal radius fractures in children : outcomes at skeletal maturity
title_full Cast versus wire fixation in displaced distal radius fractures in children : outcomes at skeletal maturity
title_fullStr Cast versus wire fixation in displaced distal radius fractures in children : outcomes at skeletal maturity
title_full_unstemmed Cast versus wire fixation in displaced distal radius fractures in children : outcomes at skeletal maturity
title_sort cast versus wire fixation in displaced distal radius fractures in children : outcomes at skeletal maturity
publishDate 2019
url http://eprints.usm.my/51086/1/Dr.%20Syurahbil%20Abdul%20Halim-24%20pages.pdf
http://eprints.usm.my/51086/
_version_ 1724074409506897920
score 13.211869

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