Centromedullary pinning using elastic stable intramedullary was first proposed by Métaizeau et al in 1980. The technique has become popular for childhood radial neck fractures but there remain difficulties in reduction. This brief technical paper adds a tip to the previous described technique. The authors report on the use of a 2.0 mm Ilizarov K-wire. The distal tips of the wires are bent sharply. The wires are then introduced to the lateral border of the distal radial metaphysis and guided all the way up to the radius. At the fracture site, the bend in the pin is erected so that it is angled with the displaced radial head. Then, the tip of the pin is engaged into the epiphysis of the radial head by gentle tapping with a mallet. Once engaged, the pin is rotated through 180-degrees so the pin faces medially and reduction has occurred. The cut end is buried at the wrist and left in situ for 6 to 8 weeks.
The authors indicate that the only suitable device of adequate length is an Ilizarov 2mm wire. The longest Nancy nail is 210 mm and the longest Kirschner wire is 150 mm. Ilizarov wires come up to 370mm which is plenty of length to expand the entire radius and use this technique. This technical tip enhances on a previously accepted procedure.
Related Links
Journal of Pediatric Orthopaedics