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Purpose: To establish the intra-operative radiographic parameters that predict the need for percutaneous wire fixation to prevent redisplacement following manipulation for displaced paediatric distal radius fractures. Materials and Methods: A retrospective study of 105 children, assessing pre-, intra- and post-operative radiographs. Optimal reduction was defined as less than 10% residual translation and less than 5° of angulation on anteroposterior and lateral radiographs. Redisplacement was defined as more than 20° angulation or 50% translation on either view. Results: No fracture that was optimally reduced redisplaced. 40% of fractures with suboptimal reduction redisplaced. Initial translation was significantly associated with redisplacement. Conclusions: If our criteria for optimal reduction are met, closed reduction and casting can be confidently employed. If not, percutaneous wires should be employed to avoid redisplacement, especially in cases with a high grade of initial translation. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the risk of neurological injury from the placement of a bicortical guidewire during subpectoral biceps tenodesis.Methods: Ten forequarter cadaver specimens were evaluated. A bicortical guidewire was placed, and measurements to important local neurological structures were made with digital calipers at open dissection.Results: The mean (range, SD) distances from the guidewire to the respective nerves was as follows: axillary nerve posteriorly, 15.7 mm (10-22 mm, 3.4); axillary nerve laterally, 18.7 mm (12-27 mm, 4.3); radial nerve posteriorly, 26.2 mm (16-35 mm, 7.0); radial nerve medially, 25 mm (16-33 mm, 4.4); and musculocutaneous nerve, 20.1 mm (12-26 mm, 5.2).Conclusions: There has been some disagreement in the literature regarding the proximity of a bicortical guidewire to the axillary nerve posteriorly. The results of this study concur with reports from several other authors and demonstrate that this nerve is at risk of iatrogenic injury when using this technique. The clinical relevance of this work is to allow surgeons to better understand the proximity of the nerve to a bicortical guidewire and to highlight that this risk is avoided with a unicortical technique. [ABSTRACT FROM AUTHOR]