Intramedullary Kirschner wire fixation of displaced distal forearm fractures in children

Abstract

Abstract Aim of the work This study was designed to highlight internal fixation by intramedullary K-wires for displaced distal forearm fractures among children and analyze the results of this technique. We hypothesize that physis-sparing intramedullary fixation prevents displacement with a lower complication rate. Methods This prospective case series involving 47 patients was conducted between February 2018 and December 2019. All patients with open physis presented with recent displaced distal forearm fractures were included, and all of them were treated with an intramedullary k-wire fixation for both bones with the assessment of the union rate, union time, suspected complication, radiographic evaluation, and functional outcome. Results The study population consisted of 31 boys (66%) and 16 girls (34%). The mean age of the patients was 10.68 ± 2.728 years (range, 7–15 years). All fractures were united in a median of 6 weeks (range, 4–8 weeks), The functional outcome after 12 months was normal in 42 patients (89.4%), whereas, in five patients (10.6%), the functional parameters were minimally reduced. The median preoperative angulation improved from 36° (range, 24°–52°) preoperatively to 4° (range, 0°–10°) on immediate postoperative radiographs. After 12 months, the median angulation was 2° (range, 0°–7°) (p < 0.001). The angulation of the distal radius immediately after surgery and at the final follow-up was statistically correlated with the functional outcome (p < 0.001 and 0.002, respectively). Conclusion This technique provides a good result with less susceptibility to re-displacement and low complication rates. Level of evidence Level IV.

Keywords

• Distal forearm fracture
• Distal radius fractures
• Intramedullary fixation
• Kirschner wire
• Pediatric wrist fractures