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European Journal of Orthopaedic Surgery & Traumatology

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Open Access 26-08-2023 | Distal Radius Fracture | Original Article

Modified Kapandji technique in pediatric displaced distal radius fractures: results in 195 patients

Authors: Cristina Bassi, Alexander F. Heimann, Joseph M. Schwab, Moritz Tannast, Ines Raabe

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 1/2024

Abstract

Purpose

The modified Kapandji technique has been proposed for fracture reduction in pediatric displaced distal radius fractures (DDRFs), but evidence is sparse. The purpose of this study was to evaluate our outcomes and complications, critically and systematically, when performing the modified Kapandji technique in pediatric DDRFs. Using this technique since 2011, we asked: (1) What is the quality of fracture reduction using this technique? (2) How stable is fracture alignment with this technique? (3) What are the postoperative complications and complication rates?

Methods

Retrospective observational study of 195 pediatric patients treated with the modified Kapandji technique. Quality of fracture reduction, fixation type (intrafocal, combined, or extrafocal), and coronal/sagittal angulation were recorded at surgery and healing. Perioperative complications were graded. Patients were stratified by fracture (metaphyseal or Salter–Harris) and fixation type, as well as age (≤ 6 years; 6 to 10 years; > 10 years).

Results

Fracture reduction was ‘good’ to ‘anatomical’ in 85% of patients. ‘Anatomical’ fracture reduction was less frequent in metaphyseal fractures (21% vs. 51%; p < .001). Mean angulation change was higher in metaphyseal fractures in both the sagittal (p = .011) and coronal (p = .021) planes. Metaphyseal fractures showed a higher mean change in sagittal angulation during fracture healing for the ‘intrafocal’ group. We observed a 15% overall complication rate with 1% being modified Sink Grade 3.

Conclusion

The modified Kapandji technique for pediatric DDRFs is a safe and effective treatment option. Metaphyseal fractures that do not involve the physis should be treated with extrafocal or combined wire fixation. Complications that require additional surgical treatment are rare.

Level of evidence

Level of evidence IV.

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Title: Modified Kapandji technique in pediatric displaced distal radius fractures: results in 195 patients
Authors: Cristina Bassi
Alexander F. Heimann
Joseph M. Schwab
Moritz Tannast
Ines Raabe
Publication date: 26-08-2023
Publisher: Springer Paris
Keywords: Distal Radius Fracture
Fracture Healing
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 1/2024
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-023-03686-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Modified Kapandji technique in pediatric displaced distal radius fractures: results in 195 patients

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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