Intramedullary Fixation Using Multiple Kirschner Wires for Forearm Fractures: A Developing Country Perspective

Journal of Orthopaedic Surgery. 2007;15 DOI 10.1177/230949900701500316

 

Journal Homepage

Journal Title: Journal of Orthopaedic Surgery

ISSN: 2309-4990 (Online)

Publisher: SAGE Publishing

Society/Institution: Asia Pacific Orthopaedic Association

LCC Subject Category: Medicine: Surgery: Orthopedic surgery

Country of publisher: United States

Language of fulltext: English

Full-text formats available: PDF, HTML

 

AUTHORS

A Abalo
A Dossim
A Assiobo
A Walla
A Ouderaogo

EDITORIAL INFORMATION

Double blind peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 13 weeks

 

Abstract | Full Text

Purpose. To evaluate treatment results of intramedullary fixation using multiple Kirschner wires for diaphyseal forearm fractures. Methods. Between January 2001 and January 2004, 184 patients (122 men and 62 women) with 288 displaced diaphyseal forearm fractures underwent intramedullary fixation using multiple Kirschner wires. The wires were inserted by opening the fracture site because radiographic facility for closed pinning was unavailable. The time to union, functional recovery, and the complication rates were assessed. Results. 11 patients were lost to follow-up, leaving 173 whose data was analysed. In 167 (97%) of the patients the fractures united, and in 14 (8%) of them union was delayed. The mean time to union for closed fractures was 13 (range, 7–16) weeks and for open fractures it was 15 (range, 12–22) weeks. The mean time in cast was 6 (range, 3–14) weeks. In all, 34/173 (20%) had complications: superficial infection (n=13), deep infection (n=4), cross-union between bones (n=4), open fracture ‘needing’ a skin graft (n=2), radial nerve palsy (n=3), paraesthesia (n=1), and non-union (n=7). Among the 173 analysed patients, the infection rate was 10% and the non-union rate was 4%. 130 (75%) of the patients had the wires removed; no re-fracture occurred after wire removal. Based on the Anderson criteria, 47 (27%) of the patients attained excellent, 78 (45%) satisfactory, and 39 (23%) unsatisfactory results. In 9 (5%) of the patients, union failed (7 plain non-union and 2 due to chronic osteomyelitis). Conclusion. Kirschner wires are much cheaper than plates and screws, and require minimal expertise for insertion and removal. They remain acceptable for stabilising displaced diaphyseal forearm fractures in developing countries.