The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

Single Bone Intramedullary Fixation of the Radius in Pediatric Both Bone Forearm Fractures Using Straight Stainless Steel Kirschner Wire: A Cross-sectional Study on Radiological and Clinical Feature

Document Type : RESEARCH PAPER

Authors
Saeed Kokly 1
Alessandro Castagna 2
Mehdi Aarabi 1
1 1 Department of Orthopedic Surgery, 5 Azar Hospital, Golestan University of Medical Sciences, Gorgan, Iran 3 Joint, Bone, Connective tissue, Rheumatology Research Center (JBCRC), Golestan University of Medical Sciences, Gorgan, Iran
2 2 Humanitas Cinical and Research Center IRCSS, Rozzano (MI)-Italy. Humanitas University, Department of Biomedical Sciences, Milan, Italy
10.22038/abjs.2023.71219.3335
Abstract
Objectives: We aimed to report radiological and clinical features of single bone intramedullary fixation 
of the radius in pediatric both bone forearm fractures using straight stainless steel Kirschner (K) wire.
Methods: Fifty-eight children (42 boys and 16 girls) referred to our hospital with both bone diaphyseal forearm 
fractures were operated on by using the single bone rigid K-wire intramedullary fixation and mini-open technique. 
The mean follow-up time was 8.9 months (6-12).
Results: The mean age of the patients was 7.4 years (4-12). More than 2/3 of the fractures were in the right hand. 
Around 63% of the fractures were in the middle third, 28% in the distal third, and 9% in the proximal third. Moreover, 
12% were open type I Gustilo-Anderson fractures. The mean time from injury to surgery was two days (1-4), and 
the mean length of hospital stay was 2.8 days (2-5). The mean duration of surgery was 24.7 minutes (18-38), and 
the mean follow-up time was 8.9 months (6-12). All fractures united within 4-16 weeks (mean: 7.62). The cast and 
implant were removed simultaneously as the radiographic fracture union. There was no serious complication. 
Superficial infection of the pin track and loosening of the pin occurred in three cases (5%), all controlled by antibiotics 
and timely removal of the pins. Mild restriction of elbow extension (less than 20 degrees) was observed in three 
cases, which returned to normal at the last follow-up. Limitation of dorsiflexion of the wrist by more than 20° occurred 
in two patients (35° and 45°), which reverted to 25° and 25°, respectively, at the last follow-up.
Conclusion: In both bone forearm fractures in children, open reduction and internal fixation of only the radius with 
a stainless steel straight Kirschner wire could be a promising method with good results. This retrograde technique 
of intramedullary fixation is a simple and cost-effective method with minimal complications and acceptable outcomes 
in children aged 4-12 years.
 Level of evidence: IV
Keywords
Both bones
Forearm
Intramedullary fixation
Kirschner wire
Radius
Subjects
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The Archives of Bone and Joint Surgery
Volume 12, Issue 3
March 2024
Pages 167-175

  • Receive Date 05 April 2023
  • Revise Date 25 January 2024
  • Accept Date 30 December 2023