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. 2022 Jan 28;30(1):e250848.
doi: 10.1590/1413-785220223001e250848. eCollection 2022.

DOES ULNA FIXATION ALTER THE OUTCOME FOR DISTAL-THIRD FOREARM FRACTURES IN CHILDREN?

Jonatas Brito DE Alencar Neto  1 , Amanda Progênio Dos Santos  1 , Guthierrez Victor DE Abreu Bezerra  1 , Luiz Holanda Pinto Neto  1 , Maria Luzete Costa Cavalcante  2
Affiliations

DOES ULNA FIXATION ALTER THE OUTCOME FOR DISTAL-THIRD FOREARM FRACTURES IN CHILDREN?

Jonatas Brito DE Alencar Neto et al. Acta Ortop Bras. .

Abstract
in English, Portuguese

Introduction: Fractures of the distal third of the forearm are common in the pediatric population. Conservative treatment of an ipsilateral fracture of the distal ulna metaphysis is one of the risk factors for loss of reduction. Percutaneous fixation of the fracture with K-wires is recommended. This study aims to evaluate the outcome of percutaneous fixation of both bones performed as the primary treatment.

Materials and methods: A randomized, open, prospective, clinical trial was conducted, including skeletally immature patients who underwent surgery for fractures of the distal radius and ulna. They were randomized into two groups, one with fixation only of the radius fracture and the other with fixation of both the radius and the ulna fractures, and they were followed clinically and radiologically for up to 12 weeks postoperatively.

Results: Sixteen children were selected. In the intraoperative period, fluoroscopy was activated for a longer time when fixing the ulna (p = 0.011) and the surgical time was longer in this group (p = 0.014). In the postoperative evaluations, the group whose surgery involved the fixation of both bones had a lower postoperative pain score (p <0.001) and less time away from school (p <0.001).

Conclusions: In this study, postoperative pain and absence from school were both less when fixation of the radius and ulna was performed. Evidence Level II; Randomized Controlled Study.

Introdução: As fraturas do terço distal do antebraço são comuns na população pediátrica. O tratamento conservador da fratura ipsilateral da metáfise distal da ulna é um dos fatores de risco para a perda da redução. Recomenda-se a fixação percutânea da fratura com fios K. Este estudo tem como objetivo avaliar o resultado da fixação percutânea de ambos os ossos realizada como tratamento primário.

Materiais e métodos: Foi realizado um estudo clínico randomizado, aberto e prospectivo, que incluiu pacientes com esqueleto imaturo que foram submetidos à cirurgia para fraturas da parte distal do rádio e a ulna. Os participantes foram randomizados em dois grupos, um com fixação apenas da fratura do rádio e outro com fixação das fraturas do rádio e da ulna, e foram acompanhados clínica e radiologicamente por até 12 semanas de pós-operatório.

Resultados: Dezesseis crianças foram selecionadas. No intraoperatório, a fluoroscopia foi ativada por mais tempo na fixação da ulna (p = 0,011) e o tempo cirúrgico foi maior nesse grupo (p = 0,014). Nas avaliações pós-operatórias, o grupo cuja cirurgia envolveu a fixação de ambos os ossos teve escore de dor menor depois da cirurgia (p < 0,001) e menos tempo de afastamento da escola (p < 0,001).

Conclusões: Neste estudo, a dor pós-operatória e o afastamento da escola foram menores quando se realizou fixação do rádio e da ulna. Nível de Evidência II; Estudo randomizado controlado.

Keywords: Bone fractures; Bone wires; Forearm.

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Conflict of interest statement

All authors declare no potential conflict of interest related to this article.

Figures

Figure 1
Figure 1. Patient enrollment as shown through a Consolidated Standards of Reporting Trials (CONSORT) 2010 flow diagram.
See this image and copyright information in PMC

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