{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T17:16:51Z","timestamp":1784999811008,"version":"3.55.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T00:00:00Z","timestamp":1717113600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T00:00:00Z","timestamp":1717113600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100012940","name":"Universit\u00e4tsklinikum T\u00fcbingen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100012940","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Trauma Emerg Surg"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Treatment of unstable forearm fractures in the metaphyseal-diaphyseal junction (MDJ) zone is still a matter of debate. Major drawbacks of all types of fixations include either invasiveness, technical impracticality, or lack of acceptance by patients. This study reports results after antegrade ESIN (a-ESIN) compared to transepiphyseal intramedullary K-wire (TIK) for unstable MDJ forearm fractures.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The MDJ of the forearm was defined as the square over the joints of both forearm bones subtracted with the square over the metaphysis of the radius alone. The data of 40 consecutive patients\u2009&lt;\u200916 years of age who were treated either by a-ESIN (later treatment period) or TIK (early treatment period) for an unstable MDJ forearm fracture at a single high-volume pediatric trauma center were retrospectively analyzed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The average age was slightly lower in the first group (TIK\u2009=\u20097.42 years; a-ESIN\u2009=\u200910.5 years). An additional ulna fracture was found in 50% of cases and was treated with a classic antegrade ESIN in 10\/20 (TIK) and 6\/20 cases (a-ESIN). Additional plaster cast immobilization was performed in all cases with TIK and in three cases with a-ESIN. After TIK, no complication, malalignment, or functional limitation occurred. After a-ESIN, 19\/20 patients had an event-free course with stable retention and healing without axial malalignment. In one case, a temporary sensor dysfunction occurred. The same patient suffered a refracture two months after the original trauma, which required a closed reduction. Metal removal was performed after 84 days (TIK) and 150 days (a-ESIN). The outcome in all patients was good.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Both a-ESIN and TIK are minimally invasive procedures that are technically easy to perform. Both methods are safe and lead to a complete restoration of the forearm\u2019s range of motion. The decisive advantage of a-ESIN is the possibility of postoperative immobilization-free rehabilitation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00068-024-02562-3","type":"journal-article","created":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T13:02:08Z","timestamp":1717160528000},"page":"2681-2687","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Treatment of unstable forearm fractures at the metaphyseal-diaphyseal junction in children: antegrade ESIN vs. transepiphyseal intramedullary K-wire fixation"],"prefix":"10.1007","volume":"50","author":[{"given":"Markus","family":"Dietzel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Scherer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Spogis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans Joachim","family":"Kirschner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Fuchs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justus","family":"Lieber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,31]]},"reference":[{"key":"2562_CR1","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1055\/s-2006-921365","volume":"14","author":"R Kraus","year":"2006","unstructured":"Kraus R, Ploss C, Staub L, Lieber J, Alt V, Weinberg AM, et al. Fractures of Long bones in children and adolescents. Osteo Trauma care. 2006;14:39\u201344.","journal-title":"Osteo Trauma care"},{"issue":"4","key":"2562_CR2","doi-asserted-by":"publisher","first-page":"e45","DOI":"10.1097\/BPO.0000000000000595","volume":"36","author":"SM Naranje","year":"2016","unstructured":"Naranje SM, Erali RA, Warner WC Jr., Sawyer JR, Kelly DM. Epidemiology of Pediatric fractures presenting to Emergency Departments in the United States. J Pediatr Orthop. 2016;36(4):e45\u20138. https:\/\/doi.org\/10.1097\/BPO.0000000000000595.","journal-title":"J Pediatr Orthop"},{"issue":"6","key":"2562_CR3","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1097\/01.bpo.0000235397.64783.d6","volume":"26","author":"P Lascombes","year":"2006","unstructured":"Lascombes P, Haumont T, Journeau P. Use and abuse of flexible intramedullary nailing in children and adolescents. J Pediatr Orthop. 2006;26(6):827\u201334. https:\/\/doi.org\/10.1097\/01.bpo.0000235397.64783.d6.","journal-title":"J Pediatr Orthop"},{"issue":"2","key":"2562_CR4","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1177\/1457496920983104","volume":"110","author":"JJ Sinikumpu","year":"2021","unstructured":"Sinikumpu JJ, Nietosvaara Y. Treatment of distal forearm fractures in children. Scand J Surg. 2021;110(2):276\u201380. https:\/\/doi.org\/10.1177\/1457496920983104.","journal-title":"Scand J Surg"},{"issue":"28","key":"2562_CR5","doi-asserted-by":"publisher","first-page":"e16353","DOI":"10.1097\/MD.0000000000016353","volume":"98","author":"R Kubiak","year":"2019","unstructured":"Kubiak R, Aksakal D, Weiss C, Wessel LM, Lange B. Is there a standard treatment for displaced pediatric diametaphyseal forearm fractures? A STROBE-compliant retrospective study. Med (Baltim). 2019;98(28):e16353. https:\/\/doi.org\/10.1097\/MD.0000000000016353.","journal-title":"Med (Baltim)"},{"key":"2562_CR6","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/s00068-005-1071-7","volume":"31","author":"J Lieber","year":"2005","unstructured":"Lieber J, Joeris A, Knorr P, Schalamon J, Schmittenbecher P. ESIN in forearm fractures: clear indications, often used, but some avoidable complications. Eur J Trauma. 2005;31:3\u201311.","journal-title":"Eur J Trauma"},{"key":"2562_CR7","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1262843","author":"J Lieber","year":"2010","unstructured":"Lieber J, Schmid E, Schmittenbecher PP. Unstable Diametaphyseal Forearm fractures: Transepiphyseal Intramedullary Kirschner-Wire fixation as a treatment option in children. Eur J Pediatr Surg. 2010. https:\/\/doi.org\/10.1055\/s-0030-1262843.","journal-title":"Eur J Pediatr Surg"},{"issue":"7","key":"2562_CR8","doi-asserted-by":"publisher","first-page":"e17763","DOI":"10.1097\/MD.0000000000017763","volume":"99","author":"G Jozsa","year":"2020","unstructured":"Jozsa G, Devecseri G, Vajda P, Juhasz Z, Varga M, Juhasz T. Distance of the fracture from the radiocarpal surface in childhood: does it determine surgical technique? A retrospective clinical study: a STROBE compliant observational study. Med (Baltim). 2020;99(7):e17763. https:\/\/doi.org\/10.1097\/MD.0000000000017763.","journal-title":"Med (Baltim)"},{"issue":"4","key":"2562_CR9","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1097\/BPO.0b013e3181d98f2c","volume":"30","author":"JM Flynn","year":"2010","unstructured":"Flynn JM, Jones KJ, Garner MR, Goebel J. Eleven years experience in the operative management of pediatric forearm fractures. J Pediatr Orthop. 2010;30(4):313\u20139. https:\/\/doi.org\/10.1097\/BPO.0b013e3181d98f2c.","journal-title":"J Pediatr Orthop"},{"key":"2562_CR10","doi-asserted-by":"crossref","unstructured":"Helber MU, Ulrich C. External fixation in forearm shaft fractures. Injury. 2000;31 Suppl 1:45\u2013\u20097. doi:S0020138399002624 [pii].","DOI":"10.1016\/S0020-1383(99)00262-4"},{"issue":"8","key":"2562_CR11","first-page":"858","volume":"85","author":"F Aribit","year":"1999","unstructured":"Aribit F, Laville JM. [Postero-medial elastic stable intramedullary nailing for anteriorly displaced distal diaphyso-metaphyseal fractures of the radius in children]. Rev Chir Orthop Reparatrice Appar Mot. 1999;85(8):858\u201360. doi:MDOI-RCO-12-1999-85-8-0035-1040-101019-ART10 [pii].","journal-title":"Rev Chir Orthop Reparatrice Appar Mot"},{"issue":"3","key":"2562_CR12","doi-asserted-by":"publisher","first-page":"269","DOI":"10.9738\/INTSURG-D-13-00065.1","volume":"99","author":"H Cai","year":"2014","unstructured":"Cai H, Wang Z, Cai H. Prebending of a titanium elastic intramedullary nail in the treatment of distal radius fractures in children. Int Surg. 2014;99(3):269\u201375. https:\/\/doi.org\/10.9738\/INTSURG-D-13-00065.1.","journal-title":"Int Surg"},{"key":"2562_CR13","doi-asserted-by":"publisher","unstructured":"Krohn C. Double Pre-bending of an Intramedullary nail is the minimal invasive osteosynthesis solution for Dia-Metaphyseal fractures of the Radius in Children: technical note and Case Series. Child (Basel). 2022;9(4). https:\/\/doi.org\/10.3390\/children9040579.","DOI":"10.3390\/children9040579"},{"issue":"4","key":"2562_CR14","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1053\/jhsu.2002.34371","volume":"27","author":"O Sato","year":"2002","unstructured":"Sato O, Aoki M, Kawaguchi S, Ishii S, Kondo M. Antegrade intramedullary K-wire fixation for distal radial fractures. J Hand Surg Am. 2002;27(4):707\u201313. https:\/\/doi.org\/10.1053\/jhsu.2002.34371.","journal-title":"J Hand Surg Am"},{"issue":"10","key":"2562_CR15","doi-asserted-by":"publisher","first-page":"e30512","DOI":"10.7759\/cureus.30512","volume":"14","author":"A Awasthi","year":"2022","unstructured":"Awasthi A, Jadhav S, Taywade S, Salwan A, Khan K. Outcome analysis of distal end Radius fractures Managed with Antegrade Intramedullary K-wire fixation. Cureus. 2022;14(10):e30512. https:\/\/doi.org\/10.7759\/cureus.30512.","journal-title":"Cureus"},{"issue":"3","key":"2562_CR16","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1097\/BTH.0000000000000430","volume":"27","author":"A Lam","year":"2023","unstructured":"Lam A, Gordon AM, Thabet AM, Abdelgawad AA. Antegrade Flexible Nailing for Pediatric Metaphyseal-Diaphyseal Junction Distal Radius fracture, is it safe? Tech Hand Up Extrem Surg. 2023;27(3):161\u20134. https:\/\/doi.org\/10.1097\/BTH.0000000000000430.","journal-title":"Tech Hand Up Extrem Surg"},{"issue":"Suppl 2","key":"2562_CR17","doi-asserted-by":"publisher","first-page":"S16","DOI":"10.1097\/BOT.0000000000002162","volume":"35","author":"M Murphy","year":"2021","unstructured":"Murphy M, Teasdall RJ, Comadoll S, Aneja A. Dorsal Thompson: Approach to the Proximal Radial Shaft. J Orthop Trauma. 2021;35(Suppl 2):S16\u20137. https:\/\/doi.org\/10.1097\/BOT.0000000000002162.","journal-title":"J Orthop Trauma"},{"issue":"10","key":"2562_CR18","doi-asserted-by":"publisher","first-page":"S135","DOI":"10.1097\/00005131-200711101-00020","volume":"21","author":"TF Slongo","year":"2007","unstructured":"Slongo TF, Audig\u00e9 L, Group obotAPC. Fracture and dislocation classification compendium for children: the AO Pediatric Comprehensive classification of long bone fractures (PCCF)1. J Orthop Trauma. 2007;21(10):S135\u201360.","journal-title":"J Orthop Trauma"},{"issue":"2","key":"2562_CR19","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1016\/j.injury.2019.01.001","volume":"50","author":"M Du","year":"2019","unstructured":"Du M, Han J. Antegrade elastic stable intramedullary nail fixation for paediatric distal radius diaphyseal metaphyseal junction fractures: a new operative approach. Injury. 2019;50(2):598\u2013601. https:\/\/doi.org\/10.1016\/j.injury.2019.01.001.","journal-title":"Injury"},{"key":"2562_CR20","unstructured":"Smith JTKJ, Waters PM, Jaramillo D, Kocher MS. The effect of pinning across the physis for stabilization of fractures in children: an MRI evaluation. Orthopaedic Journal at Harvard Medical School. 2008;10:99\u2013102. 2008."},{"issue":"5","key":"2562_CR21","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1007\/s00590-021-02952-y","volume":"31","author":"H Khan","year":"2021","unstructured":"Khan H, Green G, Arnander M, Umarji S, Gelfer Y. What are the risk factors and presenting features of premature physeal arrest of the distal radius? A systematic review. Eur J Orthop Surg Traumatol. 2021;31(5):893\u2013900. https:\/\/doi.org\/10.1007\/s00590-021-02952-y.","journal-title":"Eur J Orthop Surg Traumatol"},{"issue":"1","key":"2562_CR22","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1097\/00009957-200201000-00015","volume":"11","author":"CW Tang","year":"2002","unstructured":"Tang CW, Kay RM, Skaggs DL. Growth arrest of the distal radius following a metaphyseal fracture: case report and review of the literature. J Pediatr Orthop Part B. 2002;11(1):89\u201392. https:\/\/doi.org\/10.1097\/00009957-200201000-00015.","journal-title":"J Pediatr Orthop Part B"},{"issue":"3","key":"2562_CR23","doi-asserted-by":"publisher","first-page":"e730","DOI":"10.1097\/MJT.0000000000000031","volume":"23","author":"SH Du","year":"2016","unstructured":"Du SH, Feng YZ, Huang YX, Guo XS, Xia DD. Comparison of Pediatric Forearm fracture fixation between single- and double-Elastic stable Intramedullary Nailing. Am J Ther. 2016;23(3):e730\u20136. https:\/\/doi.org\/10.1097\/MJT.0000000000000031.","journal-title":"Am J Ther"},{"key":"2562_CR24","doi-asserted-by":"publisher","unstructured":"Johnson TR, Haus AJ, Shah KN, Bankole AI, Hogue GD. Antegrade Elastic Intramedullary nailing insertion technique results in higher incidence of symptomatic implants in Pediatric Ulnar fractures. J Am Acad Orthop Surg Glob Res Rev. 2020;4(6). https:\/\/doi.org\/10.5435\/JAAOSGlobal-D-20-00065.","DOI":"10.5435\/JAAOSGlobal-D-20-00065"},{"issue":"8","key":"2562_CR25","doi-asserted-by":"publisher","first-page":"1903","DOI":"10.1007\/s00402-021-03917-w","volume":"142","author":"M Dietzel","year":"2022","unstructured":"Dietzel M, Scherer S, Esser M, Kirschner HJ, Fuchs J, Lieber J. Fractures of the proximal radius in children: management and results of 100 consecutive cases. Arch Orthop Trauma Surg. 2022;142(8):1903\u201310. https:\/\/doi.org\/10.1007\/s00402-021-03917-w.","journal-title":"Arch Orthop Trauma Surg"},{"issue":"5","key":"2562_CR26","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1097\/01202412-200509000-00012","volume":"14","author":"A Jubel","year":"2005","unstructured":"Jubel A, Andermahr J, Isenberg J, Issavand A, Prokop A, Rehm KE. Outcomes and complications of elastic stable intramedullary nailing for forearm fractures in children. J Pediatr Orthop Part B. 2005;14(5):375\u201380.","journal-title":"J Pediatr Orthop Part B"},{"issue":"2","key":"2562_CR27","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1007\/s11832-010-0245-y","volume":"4","author":"FF Fernandez","year":"2010","unstructured":"Fernandez FF, Langendorfer M, Wirth T, Eberhardt O. Failures and complications in intramedullary nailing of children\u2019s forearm fractures. J Child Orthop. 2010;4(2):159\u201367. https:\/\/doi.org\/10.1007\/s11832-010-0245-y.","journal-title":"J Child Orthop"},{"issue":"47","key":"2562_CR28","doi-asserted-by":"publisher","first-page":"818","DOI":"10.3238\/arztebl.m2022.0259","volume":"119","author":"D Schneidmueller","year":"2022","unstructured":"Schneidmueller D, Eijkenboom A, Brand A, Langenhan R, Kertai M, Voth M, et al. To bury or not to bury-Kirschner wire fixation in children and adolescents. Dtsch Arztebl Int. 2022;119(47):818\u20139. https:\/\/doi.org\/10.3238\/arztebl.m2022.0259.","journal-title":"Dtsch Arztebl Int"},{"key":"2562_CR29","doi-asserted-by":"publisher","unstructured":"Sinikumpu JJ, Keranen J, Haltia AM, Serlo W, Merikanto J. A new mini-invasive technique in treating pediatric diaphyseal forearm fractures by bioabsorbable elastic stable intramedullary nailing: a preliminary technical report. Scand J Surg. 2013;102(4):258\u2013\u200964. https:\/\/doi.org\/10.1177\/1457496913490459.","DOI":"10.1177\/1457496913490459"},{"issue":"1","key":"2562_CR30","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1186\/s12891-022-05305-w","volume":"23","author":"M Varga","year":"2022","unstructured":"Varga M, Jozsa G, Hanna D, Toth M, Hajnal B, Krupa Z, et al. Bioresorbable implants vs. Kirschner-wires in the treatment of severely displaced distal paediatric radius and forearm fractures - a retrospective multicentre study. BMC Musculoskelet Disord. 2022;23(1):362. https:\/\/doi.org\/10.1186\/s12891-022-05305-w.","journal-title":"BMC Musculoskelet Disord"}],"container-title":["European Journal of Trauma and Emergency Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00068-024-02562-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00068-024-02562-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00068-024-02562-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T13:04:17Z","timestamp":1734959057000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00068-024-02562-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,31]]},"references-count":30,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["2562"],"URL":"https:\/\/doi.org\/10.1007\/s00068-024-02562-3","relation":{},"ISSN":["1863-9933","1863-9941"],"issn-type":[{"value":"1863-9933","type":"print"},{"value":"1863-9941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,31]]},"assertion":[{"value":"24 April 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 May 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 May 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This study was approved by the Ethical Committee of Eberhard Karls University T\u00fcbingen (project no. 630\/2019BO2).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Dr. Markus Dietzel, Dr. Simon Scherer, Dr. Jakob Spogis, Dr. Hans Joachim Kirschner, Prof. Dr. J\u00f6rg Fuchs, and Prof. Dr. Justus Lieber have no conflicts of interest or financial ties to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"This study was approved by the Ethical Committee of Eberhard.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Karls University T\u00fcbingen (project no. 630\/2019BO2).","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}