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Percutaneous intramedullary Kirschner wiring for displaced diaphyseal forearm fractures in children
Insights
Percutaneous Kirschner wire fixation is a safe and effective treatment for displaced forearm fractures in children, yielding excellent functional results with minimal complications. This method offers a convenient surgical option for pediatric forearm diaphyseal fractures.
Area of Science:
- Pediatric Orthopedics
- Surgical Techniques
- Traumatology
Background:
- Displaced forearm fractures in children often lead to conservative treatment challenges.
- High incidence of redisplacement, malunion, and functional limitations necessitate alternative interventions.
Purpose of the Study:
- To evaluate the efficacy and safety of percutaneous Kirschner (K) wire fixation for pediatric forearm diaphyseal fractures.
- To assess functional outcomes and complication rates associated with this surgical technique.
Main Methods:
- Percutaneous K wire fixation performed on 72 children under 14 years with displaced forearm fractures.
- Review of 57 patients with a mean follow-up of 20 months.
- Initial assessment of fracture angulation and reduction methods (closed vs. open).
Main Results:
- All 57 reviewed patients achieved good functional results with an excellent range of motion.
- No cases of nonunion, premature epiphyseal closure, or deep infection were reported.
- Minor angulation (10-15 degrees) observed in only five patients.
Conclusions:
- Percutaneous intramedullary K wiring is a convenient, effective, and safe surgical option for pediatric forearm diaphyseal fractures.
- The procedure is associated with minimal complications and excellent functional recovery.
- This technique provides a reliable alternative to conservative management for displaced forearm fractures in children.
Abstract:
Displaced fractures of the forearm in children are often treated conservatively, but there is a relatively high incidence of redisplacement, malunion and consequent limitation of function. We have performed percutaneous Kirschner (K) wire fixation in 72 such children under the age of 14 years, of which 57 were reviewed for our study. Both the radius and ulna were fractured in 45 (79%), the radius only in eight and the ulna only in four. The mean initial angulation was 19 degrees in the lateral plane and 9 degrees in the anteroposterior plane for the radius and 15 degrees and 9 degrees, respectively, for the ulna. In 42 patients (74%) we performed closed reduction. In the remaining 15 (26%) closed reduction failed and an open reduction, through a minimal approach, was required before K wiring. At a mean follow-up of 20 months all patients had good functional results with an excellent range of movement. Only five had angulation of from 10 degrees to 15 degrees and none had nonunion, premature epiphyseal closure or deep infection. Percutaneous intramedullary K wiring for forearm diaphyseal fracture is a convenient, effective and safe operation, with minimal complications.