A novel technique in displaced distal radius fractures not reduced via closed reduction in pediatric patients: reduction after stepwise injection of physiological saline - a case series.

BACKGROUND: The purpose of this study was to present a new method for managing displaced metaphyseal fractures of the distal radius in pediatric patients that could not be reduced by closed reduction, and to evaluate the clinical and radiological outcomes of reduction after the stepwise injection of physiological saline. METHODS: A total of 24 pediatric patients who underwent closed reduction of displaced metaphyseal distal radius fractures using the stepwise injection of physiological saline in our clinic between May 2018 and May 2020 were retrospectively examined. Follow-up visits were scheduled for all patients at three, six, and 12 months. Radiological and functional outcomes were evaluated. The Mayo Wrist Score was used in the clinical assessments, and union and deformity were assessed radiologically. RESULTS: Sixteen patients were boys and eight were girls, with a mean age of 9.38+-2.123 years. Among the etiologies of injury, falling off a bike accounted for six cases, skating injuries for five, scooter-related falls for four, falls at school for four, falls at home for three, and falls from stairs for two cases. Fourteen patients had right-sided fractures and ten had left-sided fractures. The mean number of pins used during surgery was 2.79+-0.588. The mean amount of physiological saline used during surgery was 16.25+-4.72 mL. The patients stayed in the hospital for a mean duration of 2+-0.590 days after surgery, and their mean follow-up duration was 80.54+-24.775 days. The mean time for pin removal was 4.46+-0.658 weeks. Four patients had good Mayo Wrist Scores, and 20 patients had excellent scores. During follow-up, only two patients developed pin site infections. CONCLUSION: Closed reduction and percutaneous pinning using the stepwise injection of physiological saline appears to be an effective and safe treatment technique for displaced distal radius fractures that cannot be reduced by closed reduction in pediatric patients.