OPERATIVE VERSUS NONOPERATIVE MANAGEMENT OF SALTER-HARRIS TYPE II DISTAL RADIUS FRACTURES IN CHILDREN: A...

Area of Science:

• Pediatric Orthopedics
• Pediatric Trauma
• Skeletal Development

Background:

• Salter-Harris type II distal radius fractures are common pediatric physeal injuries.
• Closed reduction with cast immobilization is standard, but concerns about reduction loss prompt Kirschner wire use.
• The benefit of routine Kirschner wire fixation after reduction is unclear.

Purpose of the Study:

• To compare radiographic outcomes of Kirschner wire fixation versus cast immobilization alone for pediatric Salter-Harris type II distal radius fractures.
• To evaluate the necessity of routine Kirschner wire fixation in managing these fractures.

Main Methods:

• Retrospective cohort study of 57 children (ages 5-16) with Salter-Harris type II distal radius fractures.
• Patients received either Kirschner wire fixation plus cast immobilization (n=30) or cast immobilization alone (n=27) after manipulation under anesthesia.
• Radiographic outcomes (radial inclination, volar tilt) were measured pre- and post-treatment.

Main Results:

• Significant radiographic alignment improvement observed in both groups.
• No statistically significant difference in final radial inclination or volar tilt between the Kirschner wire and cast-only groups.
• No complications such as pin-site infection or physeal arrest were reported.

Conclusions:

• Both Kirschner wire fixation and cast immobilization yield satisfactory early radiographic outcomes for pediatric Salter-Harris type II distal radius fractures.
• Routine Kirschner wire fixation is not universally required and should be considered for unstable fractures or older children.