Outcomes of diaphyseal forearm fractures in children treated with intramedullary kirschner wire fixation

ABSTRACT OUTCOMES OF DIAPHYSEAL FOREARM FRACTURES IN CHILDREN TREATED WITH INTRAMEDULLARY KIRSCHNER WIRE FIXATION Fracture of the forearm is common in children. These injuries are usually treated conservatively by closed reduction and casting. Operative fixation is indicated when an 'adequate' reduction cannot be achived by closed reduction or when loss of reduction develops during the cast treatment. A variety of surgical techniques are available to achieve adequate stabilisation of forearm fractures. But the use of intramedullary K-wires for fixation of forearm fractures in children is gaining favor. This retrospective study evaluates the forearm fractures in children which were fixed by intramedullary K-wires by comparing the literature. Between January 2006 and July 2011, 40 children with diaphyseal forearm fractures were treated with intramedullary K-wires at the our institution. The mean age of the patients was 10.12 [Range: 3-16] years. There were 37 male and 3 female patients. Unsuccessfull reduction in 34 patients, loss of reduction during follow-up in 6 patients, were indications for intramedullar fixation. Thirty-four were closed and 6 were open fractures. All of the open fractures were grade I, by using the Gustilo-Anderson classification. All of the fractures were treated with intramedullary K wires. For the radius, K-wire was introduced into the distal radial metaphysis, proximal to the epiphysis. For the ulna, the wire was introduced antegrade from the proximal end. Mean follow-up period was 72,85 [Range: 55-80] days. The average time for removal of the K-wires was 2 months. Patients evaluated according to Price's evaluation criterias at the last visit. According to Price's evaluation criterias, there were 19 excellent and 1 good results. Two patients had superficial pin-track infection and implant failure developed in 1 patient. Ulna wire migrated backwards in 1 patient. One patient had a hypertrophic scar. Intramedullary fixation with K-wires for the forearm diaphyseal fractures in children is a convenient, easy, effective and safe method, with minimal complications. Keywords: Child, forearm fracture, K-wires, intramedullary