{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:24:48Z","timestamp":1787027088427,"version":"build-2736575974"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Distal radius metaphyseal-diaphyseal junction (DRMDJ) fractures in children are often unstable and frequently require surgical intervention. Although various clinical approaches are available, each has its limitations. We introduced a modified external fixation technique for managing pediatric DRMDJ fractures. This study aimed to evaluate the clinical efficacy of this technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between June 2021 to June 2024, a total of 57 pediatric patients with DRMDJ fractures were reviewed retrospectively. All patients were managed using a modified external fixation technique that incorporated distraction closed reduction and fixation, thereby facilitating early functional recovery without the need for cast immobilization. Postoperative follow-up was conducted at scheduled intervals and included radiographic evaluation (x-rays), assessment of wrist function scores, and recording of patient satisfaction metrics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Successful closed reduction and application of external fixation were achieved in all 57 pediatric patients. Throughout the follow-up period, no cases of nonunion or fixation failure were observed. The treatment protocol facilitated early functional rehabilitation, as evidenced by a progressive and statistically significant improvement in Cooney scores: from 74.5\u2009\u00b1\u200910.7 at 3 weeks to 87.5\u2009\u00b1\u20097.2 at 6 weeks, 93.5\u2009\u00b1\u20094.5 at 3 months, and 96.8\u2009\u00b1\u20092.7 by 6 months postoperatively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). Postoperative surveys indicated high rates of satisfaction among patients and their families.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The modified external fixation technique for pediatric DRMDJ fractures enables early functional rehabilitation and a quicker return to school activities, while obviating the need for secondary hardware removal surgery. This approach adheres to minimally invasive principles and cosmetic acceptability, positioning it as an effective therapeutic strategy for treating pediatric DRMDJ fractures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2025.1719011","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T06:29:45Z","timestamp":1765175385000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Modified external fixation technique for treatment of distal radial metaphyseal-diaphyseal junction fractures in pediatric patients"],"prefix":"10.3389","volume":"13","author":[{"given":"Huanye","family":"Zhu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengyao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e1079","DOI":"10.5435\/JAAOS-D-23-01233","article-title":"Pediatric and adolescent distal radius fractures: current concepts and treatment recommendations","volume":"32","author":"Liu","year":"2024","journal-title":"J Am Acad Orthop Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"233","DOI":"10.3109\/17453674.2014.981781","article-title":"Malunion of distal radius fractures in children","volume":"86","author":"Jeroense","year":"2015","journal-title":"Acta Orthop"},{"key":"B3","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1302\/0301-620X.106B1.BJJ-2023-1112","article-title":"Surgically reducing displaced distal radial fractures in children","author":"Metcalfe","year":"2024","journal-title":"Bone Jt J"},{"key":"B4","doi-asserted-by":"publisher","first-page":"101","DOI":"10.4055\/cios.2017.9.1.101","article-title":"Flexible intramedullary nailing of forearm fractures at the distal metadiaphyseal junction in adolescents","volume":"9","author":"Kim","year":"2017","journal-title":"Clin Orthop Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1055\/s-0030-1262843","article-title":"Unstable diametaphyseal forearm fractures: transepiphyseal intramedullary Kirschner-wire fixation as a treatment option in children","volume":"20","author":"Lieber","year":"2010","journal-title":"Eur J Pediatr Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1177\/0300060514566650","article-title":"Fixation of distal radial epiphyseal fracture: comparison of K-wire and prebent intramedullary nail","volume":"44","author":"Cai","year":"2016","journal-title":"J Int Med Res"},{"key":"B7","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1186\/s12891-020-03404-0","article-title":"Fixation of delayed distal radial fracture involving metaphyseal diaphyseal junction in adolescents: a comparative study of crossed Kirschner-wiring and non-bridging external fixator","volume":"21","author":"Li","year":"2020","journal-title":"BMC Musculoskelet Disord"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1244704","DOI":"10.3389\/fped.2023.1244704","article-title":"Comparison of three fixation methods in paediatric metaphyseal-diaphysis junction fracture of the distal radius: a retrospective study in two centres","volume":"11","author":"Jianyi","year":"2023","journal-title":"Front Pediatr"},{"key":"B9","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1016\/j.injury.2019.01.001","article-title":"Antegrade elastic stable intramedullary nail fixation for paediatric distal radius diaphyseal metaphyseal junction fractures: a new operative approach","volume":"50","author":"Du","year":"2019","journal-title":"Injury"},{"key":"B10","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1186\/s12891-022-05305-w","article-title":"Bioresorbable implants vs. Kirschner-wires in the treatment of severely displaced distal paediatric radius and forearm fractures\u2014a retrospective multicentre study","volume":"23","author":"Varga","year":"2022","journal-title":"BMC Musculoskelet Disord"},{"key":"B11","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1055\/s-0039-1688701","article-title":"Plate fixation for unstable displaced distal radius fractures in children","volume":"8","author":"van Egmond","year":"2019","journal-title":"J Wrist Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1097\/00003086-198701000-00020","article-title":"Difficult wrist fractures. 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