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Fracture union in percutaneous Kirschner wire fixation in paediatric tibial shaft fractures
1Department of Orthopaedics, SMS&R, Sharda University, Greater Noida, UP, India.
Insights
Intramedullary Kirschner wires offer a safe and effective treatment for unstable pediatric tibial shaft fractures, achieving excellent union rates with minimal complications. This method is cost-effective and reliable for pediatric orthopedic care.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Traumatology
Background:
- Unstable tibial shaft fractures in children require effective treatment to ensure proper bone healing and minimize long-term complications.
- Percutaneous intramedullary Kirschner wire fixation is a recognized technique for pediatric long bone fractures.
Purpose of the Study:
- To evaluate the efficacy and outcomes of using intramedullary Kirschner wires for treating unstable tibial shaft fractures in pediatric patients.
- To assess union rates, complications, and overall clinical results in children treated with this method.
Main Methods:
- A prospective study involving 66 children (mean age 7.7 years) with closed tibial shaft fractures treated with percutaneous intramedullary Kirschner wires.
- Clinical results were evaluated based on union, delayed union, nonunion, and malunion criteria, with a one-year follow-up period.
Main Results:
- Excellent union was achieved in 95.45% of cases within a mean of 8 weeks.
- Complications included delayed union (4.55%), valgus deformity (1.52%), knee pain (4.55%), and skin irritation at pin sites (18.18%).
- Wires were removed without complications, and no patients were lost to follow-up.
Conclusions:
- Percutaneous intramedullary Kirschner wire fixation is a cost-effective, simple, safe, and reliable technique for unstable pediatric tibial shaft fractures.
- The method leads to good clinical results, avoids prolonged hospitalization, and demonstrates a high success rate.
Purpose:
To evaluate the efficacy of intramedullary Kirschner wires for the treatment of unstable tibial shaft fractures in children.
Methods:
This prospective study was conducted at the Department of Orthopaedic Surgery in Maharishi Markandeshwar Medical College from June 2005 to June 2010. Sixty-six children having closed fracture of the tibial shaft with a mean age of 7.7 years (range, 2-14 years) were recruited from emergency and outpatient department. They were treated with percutaneous intramedullary Kirschner wires. The clinical results of our study were rated on the basis of the criteria of union, nonunion, delayed union or malunion. All children were followed for one year.
Results:
Children achieved union in a mean time of 8 weeks (range, 6-10 weeks). Postoperatively, three children (4.55%) had delayed union, one (1.52%) valgus deformity of lower leg, three (4.55%) post- operative knee pain and twelve (18.18%) skin irritation at pin site.Wires were removed after 8-22 weeks without any complications. No patient was lost to follow-up. The results were excellent in 95.45% and good in 4.55% children.
Conclusion:
This technique is cost-effective, simple, quick to perform, safe and reliable and avoids pro- longed hospitalization with good results.
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