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Clinical Outcomes of Intramedullary Kirschner Wire Fixation for Unstable Radius and Ulna Fractures in Children: A
Abdullah Al-Moaish1,2, Anwar Mughalles1,2, Ali M Alhamzi1,2
1Department of Surgery, Sana'a University, Sana'a, YEM.
Insights
Intramedullary Kirchner wire (K-wire) fixation offers a safe and effective treatment for pediatric forearm fractures. This minimally invasive approach yields excellent functional outcomes with manageable complications, proving suitable for resource-limited settings.
Area of Science:
- Pediatric Orthopedics
- Surgical Innovation
- Trauma Management
Background:
- Pediatric forearm fractures are common, with unstable cases often needing surgery.
- Intramedullary Kirchner wire (K-wire) fixation presents a minimally invasive option with benefits like reduced tissue damage and shorter hospital stays.
- This study assesses K-wire fixation for unstable pediatric radius and ulna fractures.
Purpose of the Study:
- To evaluate the clinical outcomes of intramedullary K-wire fixation for unstable pediatric forearm fractures.
- To assess the safety and efficacy of this minimally invasive surgical technique.
- To determine the functional results and complication rates associated with K-wire fixation in children.
Main Methods:
- A prospective observational study involving 23 pediatric patients (5-15 years) with unstable forearm fractures who failed closed reduction.
- Intramedullary K-wire fixation performed under general anesthesia.
- Functional outcomes assessed using Price criteria; complications recorded; data analyzed using SPSS.
Main Results:
- Excellent functional outcomes (60.9%) and good outcomes (30.4%) were achieved.
- Common complications included pin site irritation (34.8%) and superficial wound infection (17.4%), both resolved with treatment.
- K-wire removal occurred between 12-14 weeks postoperatively for most patients (52.2%).
Conclusions:
- Intramedullary K-wire fixation is a safe and effective treatment for unstable pediatric radius and ulna fractures.
- The technique demonstrates excellent functional outcomes and manageable complications, suitable for resource-limited settings due to simplicity and cost-effectiveness.
- Further research is recommended to explore long-term outcomes and compare K-wire fixation with alternative surgical methods.
Background:
Forearm fractures are among the most common pediatric injuries, and unstable fractures often require surgical intervention. Intramedullary Kirchner wire (K-wire) fixation has emerged as a minimally invasive treatment option, offering advantages such as reduced soft tissue damage and shorter hospital stays. This study evaluated the clinical outcomes of K-wire fixation for unstable radius and ulna fractures in children.
Methods:
This prospective observational study was conducted at the Al-Thawra Modern General Hospital, Yemen, between January 1, 2019, and February 28, 2020. The study included 23 pediatric patients (aged 5-15 years) with unstable forearm fractures who had failed closed reduction. All patients underwent intramedullary K-wire fixation under general anesthesia. Functional outcomes were assessed using the Price criteria, and complications were recorded. Data were analyzed using SPSS Statistics for Windows, Version 16 (Released 2007; SPSS Inc., Chicago, United States).
Results:
The mean age of the patients was 10.4 years (range: 5-15 years), with a male predominance (69.6%, n=16). Road traffic accidents (52.2%, n=12) and falls (47.8%, n=11) were the most common mechanisms of injury. Transverse fractures accounted for 56.5% (n=13) of the cases, followed by oblique fractures (39.1%, n=9). Excellent functional outcomes were achieved in 60.9% (n=14) of the patients, and good outcomes were observed in 30.4% (n=7). Complications included pin site irritation (34.8%, n=8) and superficial wound infection (17.4%, n=4), all of which were resolved with appropriate treatment. The majority of patients (52.2%, n=12) underwent K-wire removal between 12 and 14 weeks postoperatively.
Conclusion:
Intramedullary K-wire fixation is a safe and effective treatment for unstable radial and ulnar fractures in children, with excellent functional outcomes and manageable complications. The proposed technique is particularly suitable for resource-limited settings because of its simplicity and cost-effectiveness. Future studies should explore long-term outcomes and compare K-wire fixation with other surgical techniques.
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