Related Experiment Video
Updated: Jan 8, 2026
Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
Infectious complications of K-wire fixation in pediatric fractures: Risk factors and management at a tertiary care
Matteo Palmetti1, Elisabetta Venturini2, Agnese Tamborino2
1Department of Health Sciences, Postgraduate School of Pediatrics, University of Florence, Florence, Italy.
Insights
Infections following pediatric Kirschner wire fixation are rare, occurring in 2.4% of cases. Younger children and summer surgeries increase infection risk, highlighting the need for careful management and patient education.
Area of Science:
- Orthopedic Surgery
- Pediatric Medicine
- Infectious Diseases
Background:
- Kirschner wires (K-wires) are common for pediatric fracture fixation.
- Infection rates vary (1-20%), with limited pediatric-specific data.
- Infections range from pin tract infections (PTIs) to osteomyelitis.
Purpose of the Study:
- Evaluate infection rates after K-wire fixation in children.
- Describe clinical presentations and risk factors.
- Identify common pathogens and assess treatment strategies.
Main Methods:
- Retrospective observational study (2020-2024).
- Included children (0-18 years) with K-wire fixation for fractures.
- Data collected on infections, pathogens, and risk factors.
Main Results:
- 2.4% infection rate (33/1386 patients).
- Pin tract infections (48.5%) and osteomyelitis (33.3%) were most common.
- Younger children (<9 years) and summer surgeries showed increased infection risk.
Conclusions:
- K-wire fixation in pediatric patients has a low infection rate (2.4%).
- Patient education on wound and cast care is crucial.
- Infections are rare but require vigilant management.
Introduction:
Kirschner wires (K-wires) are frequently used for pediatric fracture fixation. Infectious complications range from 1 % to 20 %, but the few available studies mostly focus on the adult population. The severity of infection varies from minor pin tract infections (PTIs) to severe osteomyelitis. Current literature on this topic is limited, especially regarding the pediatric population.
Methods:
In this retrospective observational study, we enrolled children (0-18 years old) with traumatic bone fractures treated with smooth (unthreaded) K-wires at the Orthopedics Unit of Meyer Children's Hospital in Florence between January 1, 2020, and December 31, 2024. The aim was to evaluate infection rates at our institution, describe clinical presentations and risk factors, identify the most frequent pathogens, and assess the treatment strategies adopted.
Results:
A total of 1386 patients were included, of whom 1349 (97.3 %) had fractures of the upper extremities (including the hand) and 37 (2.7 %) had fractures of the lower extremities (including the foot). We recorded 33 infections, with an infection rate of 2.4 %. PTIs were the most common infectious complication (16/33, 48.5 %), followed by osteomyelitis (11/33, 33.3 %) and deep soft tissue infections (3/33, 9.1 %). Fever of unknown origin (FUO), associated with elevated inflammatory markers, was observed in 3/33 (9.1 %) patients. The most common pathogen was Staphylococcus aureus, with no cases of methicillin-resistant strains. Children younger than 9 years were 2.8 times more likely to develop an infectious complication, as confirmed by both univariate (p = 0.012) and multivariate analysis (p = 0.036). Surgery during the summer season was significantly associated with a twofold increased risk of infection in univariate (p = 0.014) and multivariate analysis (p = 0.033). The timing of surgery, number of wires, fracture site, and type of reduction were not associated with a higher risk of infection.
Conclusion:
This study describes the infection rate following K-wire fixation in a large pediatric cohort at a tertiary care facility. Based on our findings, these complications are rare, and patient education on wound and cast care may play a role in reducing their occurrence.
More Related Videos
04:19Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
Published on: November 8, 2024
15:11Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling
Published on: January 5, 2015
Related Concept Videos
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:29Endocarditis IV: Nursing Management
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:25Urinary Tract Calculi VI: Surgical Management