Single or double Kirschner wire fixation: which provides better outcomes for pediatric proximal phalanx base...

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Hand surgery

Background:

• Proximal phalanx base fractures are the most common hand fractures in children.
• Kirschner wire (K-wire) pinning is a standard treatment for these fractures.
• The optimal number of K-wires for fixation remains a subject of clinical consideration.

Purpose of the Study:

• To compare the clinical outcomes of single versus double K-wire pinning for pediatric proximal phalanx base fractures.
• To evaluate differences in complication rates, functional outcomes, and operative time between the two fixation methods.

Main Methods:

• Retrospective analysis of 37 pediatric patients with proximal phalanx base fractures treated with closed K-wire pinning (January 2016 - February 2022).
• Patients were categorized into single (n=10) or double (n=27) K-wire groups.
• Outcomes assessed included operative time, complication rates, implant removal time, Michigan Hand Outcomes Questionnaire (MHQ) scores, diaphyseal axis-metacarpal head angle (DHA), and Total Active Flexion Scale (TAFS).

Main Results:

• The single K-wire group had a significantly shorter mean operation time compared to the double K-wire group.
• No significant differences were found between the groups regarding complication rates, TAFS, implant removal times, MHQ scores, or pre- and post-operative DHA.
• Both single and double K-wire techniques yielded comparable functional and radiographic outcomes.

Conclusions:

• Single K-wire pinning is an effective alternative to double K-wire pinning for pediatric proximal phalanx base fractures.
• The single K-wire technique offers the advantage of reduced operative time.
• Treatment choice should be guided by surgeon expertise and patient-specific factors.