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Purpose <p>The optimal fixation method for distal radial metaphyseal–diaphyseal junction (DRMDJ) fractures in children remains controversial. This study aims to compare the clinical and radiological outcomes of double pre-bending elastic stable intramedullary nailing (DPB-ESIN) and external fixation (EF) in the treatment of pediatric DRMDJ fractures.</p> Methods <p>A retrospective analysis was conducted on children with DRMDJ fractures who underwent surgery between May 2022 and May 2024. Patients were divided into two groups based on the fixation method: the DPB-ESIN group and the EF group. Demographic characteristics, clinical history, intraoperative details, follow-up outcomes, and complications were documented. Statistical differences between the two groups were analyzed.</p> Results <p>The DPB-ESIN group included 20 patients, while the EF group also included 20 patients. The baseline characteristics of the two groups were comparable. No significant differences were observed between the groups in terms of operative time, intraoperative fluoroscopy frequency, fracture translation or angulation correction, fracture healing time, and functional recovery of the wrist and the forearm at 6&#xa0;months postoperatively. However, the DPB-ESIN group demonstrated lower Gartland–Werley wrist scores at 2&#xa0;months postoperatively, lower VSS scores at 6&#xa0;months postoperatively compared to the EF group.</p> Conclusion <p>Both DPB-ESIN and EF provide excellent functional and radiographic outcomes at 6&#xa0;months postoperatively for pediatric DRMDJ fractures. The EF technique is technically simple and does not require secondary surgery for implant removal, while the DPB-ESIN technique promotes earlier complete functional recovery at 2&#xa0;months postoperatively, produces more esthetic scars, and has a potentially lower incidence of infections.</p>

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Comparison of Double Pre-bending Elastic Stable Intramedullary Nailing and External Fixation for the Treatment of Distal Radial Metaphyseal–Diaphyseal Junction Fractures in Children

  • 期刊论文

  • 发表日期：

    2026年3月3日

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  • Tian Chen,
  • Yuwei Wen,
  • Danjiang Zhu,
  • Wei Feng,
  • Baojian Song,
  • Qiang Wang

摘要

Purpose

The optimal fixation method for distal radial metaphyseal–diaphyseal junction (DRMDJ) fractures in children remains controversial. This study aims to compare the clinical and radiological outcomes of double pre-bending elastic stable intramedullary nailing (DPB-ESIN) and external fixation (EF) in the treatment of pediatric DRMDJ fractures.

Methods

A retrospective analysis was conducted on children with DRMDJ fractures who underwent surgery between May 2022 and May 2024. Patients were divided into two groups based on the fixation method: the DPB-ESIN group and the EF group. Demographic characteristics, clinical history, intraoperative details, follow-up outcomes, and complications were documented. Statistical differences between the two groups were analyzed.

Results

The DPB-ESIN group included 20 patients, while the EF group also included 20 patients. The baseline characteristics of the two groups were comparable. No significant differences were observed between the groups in terms of operative time, intraoperative fluoroscopy frequency, fracture translation or angulation correction, fracture healing time, and functional recovery of the wrist and the forearm at 6 months postoperatively. However, the DPB-ESIN group demonstrated lower Gartland–Werley wrist scores at 2 months postoperatively, lower VSS scores at 6 months postoperatively compared to the EF group.

Conclusion

Both DPB-ESIN and EF provide excellent functional and radiographic outcomes at 6 months postoperatively for pediatric DRMDJ fractures. The EF technique is technically simple and does not require secondary surgery for implant removal, while the DPB-ESIN technique promotes earlier complete functional recovery at 2 months postoperatively, produces more esthetic scars, and has a potentially lower incidence of infections.