Antegrade Elastic Stable Intramedullary Nail Fixation For Paediatric Distal Radius Diaphyseal Metaphyseal Junction Fractures

Purpose: The purpose of the study was to introduce a new operative approach at the proximal “safe zone” of the posterior interosseous nerve(PIN)using elastic stable intramedullary nailing(ESIN)to treat pediatric distal radius diaphyseal-metaphyseal junction(DRDMJ)fractures and compare the radiographic and functional outcomes of antegrade ESIN fixation with those of plate fixation.Methods: We performed a retrospective review of all patients treated by either open reduction and internal fixation(ORIF)with a plate and screws or antegrade ESIN fixation following a pediatric DRDMJ fracture between August 2015 and July 2018.Patient demographic and outcome variables were compared between the plate and nail fixation groups.Results: Sixty patients(mean age,10.9 years;range,8–15 years),43 males and 17 females,met the inclusion criteria.The nail fixation group included thirty-six patients,26 boys and 10 girls,and the plate fixation group included 24 patients,17 boys and 7 girls.The nail fixation group had a shorter duration of surgery,less estimated blood loss,and a longer duration of intraoperative fluoroscopy than the plate fixation group(P < 0.01).The two groups obtained good functional and radiographic outcomes and had similar complication rates.Conclusions: Antegrade ESIN fixation of pediatric DRDMJ fractures was an easy,minimally invasive and safe method,had similar functional and radiographic outcomes compared with plate fixation,and was our treatment of choice.