Ilizarov method in the treatment of children with periarticular fractures
https://doi.org/10.18019/1028-4427-2021-27-4-418-423
Abstract
Introduction. Periarticular injuries in children include types I and II fractures according to the Salter-Harris classification and metaphyseal fractures. In most cases, conservative treatment is an effective method, but in some cases, surgical treatment, including external fixation, is the method of choice.
Purpose. Discussion of the principles of using the Ilizarov apparatus in the treatment of children with periarticular fractures of various locations, its advantages and disadvantages.
Materials and methods. We present the principles and features of the Ilizarov surgical techniques for treatment of children with periarticular fractures of the distal humerus, femur, radius and tibia.
Discussion. The methods of osteosynthesis for pediatric periarticular fractures imply transphyseal introduction of fixators that have a potential threat of iatrogenic damage to the growth plate in contrast to external fixation which performance implies that transosseous elements do not injure the growth zone, providing stable fixation of bone fragments in combination with early functional recovery of the damaged segment which is a key advantage over other methods.
Conclusion. The use of the Ilizarov apparatus enables to achieve the desired result in the treatment of pediatric periarticular fractures and has a number of advantages over other methods of surgical treatment.
About the Authors
A. A. Korobeinikov
Ilizarov National Medical Research Centre for Traumatology and Orthopedics;
Kurgan Regional Children's Clinical Hospital named after the Red Cross
Russian Federation
Russian Federation
Anatoly A. Korobeinikov, M.D., Ph.D.,
Kurgan
A. M. Aranovich
Ilizarov National Medical Research Centre for Traumatology and Orthopedics
Russian Federation
Russian Federation
Anna M. Aranovich, M.D., Ph.D., Professor,
Kurgan
D. A. Popkov
Ilizarov National Medical Research Centre for Traumatology and Orthopedics
Russian Federation
Russian Federation
Dmitry A. Popkov, M.D., Ph.D., Professor of RAS, correspondent member French Academy of Medical Sciences,
Kurgan
References
1. Salter R.B., Harris W.R. Injuries involving the epiphyseal plate. J. Bone Joint Surg. Am., 1963, vol. 45, no. 3, pp. 587-622.
2. Bohn W.W., Durbin R.A. Ipsilateral fractures of the femur and tibia in children and adolescents. J. Bone Joint Surg. Am., 1991, vol. 73, no. 3, pp. 429-439.
3. Cannata G., De Maio F., Mancini F., Ippolito E. Physeal fractures of the distal radius and ulna: long-term prognosis. J. Orthop. Trauma, 2003, vol. 17, no. 3, pp. 172-179. DOI: 10.1097/00005131-200303000-00002.
4. Harley B.J., Scharfenberger A., Beaupre L.A., Jomha N., Weber D.W. Augmented external fixation versus percutaneous pinning and casting for unstable fractures of the distal radius – a prospective randomized trial. J. Hand Surg. Am., 2004, vol. 29, no. 5, pp. 815-824. DOI: 10.1016/j.jhsa.2004.05.006.
5. Franz T., Jandali A.R., Jung F.J., Leclère F.M., von Wartburg U., Hug U. Functional-conservative treatment of extra-articular physeal fractures of the proximal phalanges in children and adolescents. Eur. J. Pediatr. Surg., 2013, vol. 23, no. 4, pp. 317-321. DOI: 10.1055/s-0033-1333636.
6. Park H., Lee D.H., Han S.H., Kim S., Eom N.K., Kim H.W. What is the best treatment for displaced Salter-Harris II physeal fractures of the distal tibia? Acta Orthop., 2018, vol. 89, no. 1, pp. 108-112. DOI: 10.1080/17453674.2017.1373496.
7. Peterson H.A. Epiphyseal growth plate fractures. Berlin, Heidelberg, Springer-Verlag, 2007, 914 p. DOI: 10.1007/978-3-540-33802-4.
8. Valverde J.A., Albiñana J., Certucha J.A. Early posttraumatic physeal arrest in distal radius after a compression injury. J. Pediatr. Orthop. B, 1996, vol. 5, no. 1, pp. 57-60. DOI: 10.1097/01202412-199605010-00012.
9. Franz T., von Wartburg U., Schibli-Beer S., Jung F.J., Jandali A.R., Calcagni M., Hug U. Extra-articular fractures of the proximal phalanges of the fingers: a comparison of 2 methods of functional, conservative treatment. J. Hand Surg. Am., 2012, vol. 37, no. 5, pp. 889-898. DOI: 10.1016/j.jhsa.2012.02.017.
10. Joeris A., Lutz N., Blumenthal A., Slongo T., Audigé L. The AO pediatric comprehensive classification of long bone fractures (PCCF). Acta Orthop., 2017, vol. 88, no. 2, pp. 129-132. DOI: 10.1080/17453674.2016.1258533.
11. Audigé L., Slongo T., Lutz N., Blumenthal A., Joeris A. The AO pediatric comprehensive classification of long bone fractures (PCCF). Acta Orthop., 2017, vol. 88, no. 2, pp. 133-139. DOI: 10.1080/17453674.2016.1258534.
12. Anari J.B., Neuwirth A.L., Horn B.D., Baldwin K.D. Ipsilateral femur and tibia fractures in pediatric patients: a systematic review. World J. Orthop., 2017, vol. 8, no. 8, pp. 638-643. DOI: 10.5312/wjo.v8.i8.638.
13. Karlikowski M., Sułko J. Physeal fractures of the lower leg in children and adolescents: therapeutic results, pitfalls and suggested management protocol based on the experience of the authors and contemporary literature. Adv. Med. Sci., 2018, vol. 63, no. 1, pp. 107-111. DOI: 10.1016/j.advms.2017.10.001.
14. Özkul B., Saygılı M.S., Çetinkaya E., Arslanoğlu F., Bayhan I.A., Demir B., Tekin A.C. Angular deformity development after the distal tibial physeal fractures. Acta Orthop. Belg., 2016, vol. 82, no. 4, pp. 814-820.
15. Chia B., Kozin S.H., Herman M.J., Safier S., Abzug J.M. Complications of pediatric distal radius and forearm fractures. Instr. Course Lect., 2015, vol. 64, pp. 499-507.
16. Dua K., Abzug J.M., Sesko Bauer A., Cornwall R., Wyrick T.O. Pediatric distal radius fractures. Instr. Course Lect., 2017, vol. 66, pp. 447-460.
17. Otayek S., Ramanoudjame M., Fitoussi F. Les fractures de l’extrémité distale du radius chez l’enfant [Distal radius fractures in children]. Hand Surg. Rehabil., 2016, vol. 35S, pp. S150-S155. DOI: 10.1016/j.hansur.2016.02.013. (in French)
18. Larsen M.C., Bohm K.C., Rizkala A.R., Ward C.M. Outcomes of nonoperative treatment of Salter-Harris II distal radius fractures: a systematic review. Hand (N Y), 2016, vol. 11, no. 1, pp. 29-35. DOI: 10.1177/1558944715614861.
19. Jordan R.W., Westacott D., Srinivas K., Shyamalan G. Predicting redisplacement after manipulation of paediatric distal radius fractures: the importance of cast moulding. Eur. J. Orthop. Surg. Traumatol., 2015, vol. 25, no. 5, pp. 841-845. DOI: 10.1007/s00590-015-1627-0.
20. Hill C.E., Cooke S. Common paediatric elbow injuries. Open Orthop. J., 2017, vol. 11, pp. 1380-1393. DOI: 10.2174/1874325001711011380.
21. Javanović V., Vukasinović Z., Seslija I. [Complicated distal femoral epiphyseolysis treated by Ilizarov method: case report]. Srp. Arh. Celok. Lek., 2010, vol. 138, no. 5-6, pp. 367-370. (in Serbian) DOI: 10.2298/sarh1006367j.
22. Eid A.M., Hafez M.A. Traumatic injuries of the distal femoral physis. Retrospective study on 151 cases. Injury, 2002, vol. 33, no. 3, pp. 251-255. DOI: 10.1016/s0020-1383(01)00109-7.
23. Skaggs D.L., Hale J.M., Buggay S., Kay R.M. Use of a hybrid external fixator for a severely comminuted juxta-articular fracture of the distal humerus. J. Orthop. Trauma, 1998, vol. 12, no. 6, pp. 439-442. DOI: 10.1097/00005131-199808000-00015.
24. Manoj Kumar P.P., Salgotra K.R. Clinico-radiological evaluation of juxta articular fractures and diaphyseal fractures of upper limb managed with locking compression plating. Med. J. Armed Forces India, 2012, vol. 68, no. 3, pp. 211-213. DOI: 10.1016/j.mjafi.2012.03.008.
25. Reyes F.A., Latta L.L. Conservative management of difficult phalangeal fractures. Clin. Orthop. Relat. Res., 1987, no. 214, pp. 23-30.
26. Lagrange J., Rigault P. Fractures supracondyliennes [Supracondylar fractures]. Rev. Chir. Orthop., 1962, vol. 48, pp. 337-414. (in French)
27. Zhao C. [Outcomes of different operations for distal forearm fractures in children]. Zhonghua Yi Xue Za Zhi, 2015, vol. 95, no. 15, pp. 1168-1170. (in Chinese) DOI: 10.3760/cma.j.issn.0376-2491.2015.15.012.
28. Spiegel P.G., Mast J.W. Internal and external fixation of fractures in children. Orthop. Clin. North Am., 1980, vol. 11, no. 3, pp. 405-421.
29. Lascombes P. Flexible intramedullary nailing in children. The Nancy University manual. Berlin, Heidelberg, Springer-Verlag, 2010.
30. Lascombes P., Huber H., Fay R., Popkov D., Haumont T., Journeau P. Flexible intramedullary nailing in children: nail to medullary canal diameters optimal ratio. J. Pediatr. Orthop., 2013, vol. 33, no. 4, pp. 403-408. DOI: 10.1097/BPO.0b013e318285c54d.
31. Prévot J., Lascombes P., Métaizeau J.P., Blanquart D. Fractures supra-condyliennes de l'humérus de l'enfant: traitement par embrochage descendant [Supracondylar fractures of the humerus in children: treatment by downward nailing]. Rev. Chir. Orthop. Reparatrice Appar. Mot., 1990, vol. 76, no. 3, pp. 191-197. (in French)
32. Or O., Weil Y., Simanovsky N., Panski A., Goldman V., Lamdan R. The outcome of early revision of malaligned pediatric supracondylar humerus fractures. Injury, 2015, vol. 46, no. 8, pp. 1585-1590. DOI: 10.1016/j.injury.2015.04.022.
33. Eberl R., Weinberg A.M. Posttraumatische Korrekturoperationen am kindlichen Ellenbogen [Operative corrections of posttraumatic deformities of the elbow joint in children]. Unfallchirurg, 2010, vol. 113, no. 2, pp. 139-148. DOI: 10.1007/s00113-009-1728-1725. (in German)
34. Slongo T. Radialer externer Fixateur zur geschlossenen Behandlung problematischer suprakondylärer Humerusfrakturen Typ III und IV bei Kindern und Jugendlichen. Eine neue chirurgische Technik [Radial external fixator for closed treatment of type III and IV supracondylar humerus fractures in children. A new surgical technique]. Oper. Orthop. Traumatol., 2014, vol. 26, no. 1, pp. 75-96. (in German) DOI: 10.1007/s00064-013-0291-y.
35. Gugenheim J.J. Jr. The Ilizarov fixator for pediatric and adolescent supracondylar fracture variants. J. Pediatr. Orthop., 2000, vol. 20, no. 2, pp. 177-182.
36. Prashant K., Lakhotia D., Bhattacharyya T.D., Mahanta A.K., Ravoof A. A comparative study of two percutaneous pinning techniques (lateral vs medial-lateral) for Gartland type III pediatric supracondylar fracture of the humerus. J. Orthop. Traumatol., 2016, vol. 17, no. 3, pp. 223-229. DOI: 10.1007/s10195-016-0410-2.
37. Hohloch L., Konstantinidis L., Wagner F.C., Strohm P.C., Südkamp N.P., Reising K. Biomechanical comparison of different external fixator configurations for stabilization of supracondylar humerus fractures in children. Clin. Biomech. (Bristol, Avon), 2016, vol. 32, pp. 118-123. DOI: 10.1016/j.clinbiomech.2015.12.003.
38. Ramoutar D.N., Shivji F.S., Rodrigues J.N., Hunter J.B. The outcomes of displaced paediatric distal radius fractures treated with percutaneous Kirschner wire fixation: a review of 248 cases. Eur. J. Orthop. Surg. Traumatol., 2015, vol. 25, no. 3, pp. 471-476. DOI: 10.1007/s00590-014-1553-6.
39. Wójcik K., Wojciechowski P., Kusz D. Leczenie operacyjne urazowego uszkodzenia dalszej nasady kości udowej typu II wg Saltera-Harrisa [Surgical treatment for Salter-Harris type II distal femoral epiphysis injury]. Chir. Narzadow Ruchu Ortop. Pol., 1998, vol. 63, no. 2, pp. 143-149. (in Polish)
40. Oberle M., Bonetta M., Schlickewei W. Operative Therapie der kniegelenknahen Epiphyseolyse [Surgical treatment of epiphysiolyses of the distal femur and the proximal tibia]. Oper. Orthop. Traumatol., 2008, vol. 20, no. 4-5, pp. 387-395. DOI: 10.1007/s00064-008-1410-z. (in German)
41. Edgard-Rosa G., Launay F., Glard Y., Guillaume J.M., Jouve J.L., Bollini G. Fractures-décollements épiphysaires de type SalterII de l'extrémité distale du fémur chez l'adolescent : nouvelle proposition thérapeutique (étude préliminaire) [Salter and Harris type-II distal femoral physeal fractureseparations at adolescent age: a new therapeutic approach (preliminary study)]. Rev. Chir. Orthop. Reparatrice Appar. Mot., 2008, vol. 94, no. 6, pp. 546-551. (in French) DOI: 10.1016/j.rco.2008.01.007.
42. Wei S.W., Shi Z.Y., Hu J.Z., Wu H. [Treatment of pediatric distal femur fractures by external fixator combined with limited internal fixation]. Zhongguo Gu Shang, 2016, vol. 29, no. 3, pp. 275-278. (in Chinese)
43. Popkov D., Lascombes P., Berte N., Hetzel L., Baptista B.R., Popkov A., Journeau P. The normal radiological anteroposterior alignment of the lower limb in children. Skeletal Radiol., 2015, vol. 44, no. 2, pp. 197-206. DOI: 10.1007/s00256-014-1953-z.
44. D'Angelo F., Solarino G., Tanas D., Zani A., Cherubino P., Moretti B. Outcome of distal tibia physeal fractures: a review of cases as related to risk factors. Injury, 2017, vol. 48, no. Suppl. 3, pp. S7-S11. DOI: 10.1016/S0020-1383(17)30650-2.
45. Barmada A., Gaynor T., Mubarak S.J. Premature physeal closure following distal tibia physeal fractures: a new radiographic predictor. J. Pediatr. Orthop., 2003, vol. 23, no. 6, pp. 733-739. DOI: 10.1097/00004694-200311000-00010.
46. Korobeinikov A., Popkov D. Use of external fixation for juxta-articular fractures in children. Injury, 2019, vol. 50, no. Suppl. 1, pp. S87-S94. DOI: 10.1016/j.injury.2019.03.043.
47. Sysenko Iu.M., Nasyrov M.Z. Lechenie detei s epi- i osteoepifizeolizami dlinnykh trubchatykh kostei metodom chreskostnogo osteosinteza po Ilizarovu [Treatment of children with epi- and osteoepiphysiolyses of long tubular bones using the transosseous osteosynthesis technique according to Ilizarov]. Genij Ortopedii, 2001, no. 4, pp. 92-96. (in Russian)
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For citations:
Korobeinikov A.A., Aranovich A.M., Popkov D.A. Ilizarov method in the treatment of children with periarticular fractures. Genij Ortopedii. 2021;27(4):418-423. https://doi.org/10.18019/1028-4427-2021-27-4-418-423
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