ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2024
Treatment of unstable forearm fractures at the metaphyseal-diaphyseal junction in children: antegrade ESIN vs. transepiphyseal intramedullary K-wire fixation.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Radial entry for ESIN fixation of pediatric radial fractures: a 10-year cohort study with focus on neurological complications.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
- [Comparative analysis of effectiveness of two single-pin internal fixation techniques in treatment of pediatric distal radial metaphyseal diaphyseal junction fractures].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026Article
- [Shaft fractures in children and adolescents: age-appropriate treatment strategies].Unfallchirurgie (Heidelberg, Germany) · 2025Review
- Article
- Introducing the forearm fracture index to define the diametaphyseal junction zone through clinical evaluation in a cohort of 366 diametaphyseal radius fractures.Archives of orthopaedic and trauma surgery · 2025Article
- Pediatric skeletal trauma - current aspects.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
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6 authors.
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Abstract
backgroundTreatment of unstable forearm fractures in the metaphyseal-diaphyseal junction (MDJ) zone is still a matter of debate. Major drawbacks of all types of fixations include either invasiveness, technical impracticality, or lack of acceptance by patients. This study reports results after antegrade ESIN (a-ESIN) compared to transepiphyseal intramedullary K-wire (TIK) for unstable MDJ forearm fractures.
methodsThe MDJ of the forearm was defined as the square over the joints of both forearm bones subtracted with the square over the metaphysis of the radius alone. The data of 40 consecutive patients < 16 years of age who were treated either by a-ESIN (later treatment period) or TIK (early treatment period) for an unstable MDJ forearm fracture at a single high-volume pediatric trauma center were retrospectively analyzed.
resultsThe average age was slightly lower in the first group (TIK = 7.42 years; a-ESIN = 10.5 years). An additional ulna fracture was found in 50% of cases and was treated with a classic antegrade ESIN in 10/20 (TIK) and 6/20 cases (a-ESIN). Additional plaster cast immobilization was performed in all cases with TIK and in three cases with a-ESIN. After TIK, no complication, malalignment, or functional limitation occurred. After a-ESIN, 19/20 patients had an event-free course with stable retention and healing without axial malalignment. In one case, a temporary sensor dysfunction occurred. The same patient suffered a refracture two months after the original trauma, which required a closed reduction. Metal removal was performed after 84 days (TIK) and 150 days (a-ESIN). The outcome in all patients was good.
conclusionBoth a-ESIN and TIK are minimally invasive procedures that are technically easy to perform. Both methods are safe and lead to a complete restoration of the forearm's range of motion. The decisive advantage of a-ESIN is the possibility of postoperative immobilization-free rehabilitation.
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