Antegrade intrafocal Kapandji pinning technique for volar displaced distal radius fractures in older children

Distal radius fractures in older children pose a challenge in terms of treatment due to the lack of specific guidelines and controversies surrounding the optimal approach. The purpose of this study was to examine the effectiveness of antegrade intrafocal pinning (AIP) in treating volar displaced distal radius fractures in older children.

This was a retrospective study of 12 consecutive patients with volar displaced distal radius fractures treated with an antegrade intra-focal pinning technique between 2017 and 2021. The study evaluated functional outcomes using the quick DASH score, modified Mayo wrist score, and grip strength. MRI of the wrist was done in all patients two years after the initial surgery.

The mean follow-up period of the study was 26 months (range 20–32 months). All patients achieved radiological union. The mean range of wrist flexion was 74°, extension 52°, radial deviation 22°, ulnar deviation 27°, and grip strength was 96% of the opposite side. The visual analogue scale score was 0 (range 0–1), and the quick DASH score was 4.3. The mean Mayo wrist score was 84 (range 80–85). None of the patients experienced growth arrest, growth plate deformity, physeal bar, or bridges on MRI.

The AIP technique is safe and effective for treating volar displaced distal radius fractures in older children. The technique provides good radiological union and functional outcomes without physeal or growth plate injuries.

Level IV, Therapeutic