Cureus · 2025
Clinical Outcomes of Intramedullary Kirschner Wire Fixation for Unstable Radius and Ulna Fractures in Children: A Prospective Study in Yemen.
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Al-Moaish Abdullah, Mughalles Anwar, Alhamzi Ali M, Alqadasi Bassam T, Jowah Haitham M
Аннотация
BACKGROUND: Forearm fractures are among the most common pediatric injuries, and unstable fractures often require surgical intervention. Intramedullary Kirchner wire (K-wire) fixation has emerged as a minimally invasive treatment option, offering advantages such as reduced soft tissue damage and shorter hospital stays. This study evaluated the clinical outcomes of K-wire fixation for unstable radius and ulna fractures in children.
METHODS: This prospective observational study was conducted at the Al-Thawra Modern General Hospital, Yemen, between January 1, 2019, and February 28, 2020. The study included 23 pediatric patients (aged 5-15 years) with unstable forearm fractures who had failed closed reduction. All patients underwent intramedullary K-wire fixation under general anesthesia. Functional outcomes were assessed using the Price criteria, and complications were recorded. Data were analyzed using SPSS Statistics for Windows, Version 16 (Released 2007; SPSS Inc., Chicago, United States).
RESULTS: The mean age of the patients was 10.4 years (range: 5-15 years), with a male predominance (69.6%, n=16). Road traffic accidents (52.2%, n=12) and falls (47.8%, n=11) were the most common mechanisms of injury. Transverse fractures accounted for 56.5% (n=13) of the cases, followed by oblique fractures (39.1%, n=9). Excellent functional outcomes were achieved in 60.9% (n=14) of the patients, and good outcomes were observed in 30.4% (n=7). Complications included pin site irritation (34.8%, n=8) and superficial wound infection (17.4%, n=4), all of which were resolved with appropriate treatment. The majority of patients (52.2%, n=12) underwent K-wire removal between 12 and 14 weeks postoperatively.
CONCLUSION: Intramedullary K-wire fixation is a safe and effective treatment for unstable radial and ulnar fractures in children, with excellent functional outcomes and manageable complications. The proposed technique is particularly suitable for resource-limited settings because of its simplicity and cost-effectiveness. Future studies should explore long-term outcomes and compare K-wire fixation with other surgical techniques.
METHODS: This prospective observational study was conducted at the Al-Thawra Modern General Hospital, Yemen, between January 1, 2019, and February 28, 2020. The study included 23 pediatric patients (aged 5-15 years) with unstable forearm fractures who had failed closed reduction. All patients underwent intramedullary K-wire fixation under general anesthesia. Functional outcomes were assessed using the Price criteria, and complications were recorded. Data were analyzed using SPSS Statistics for Windows, Version 16 (Released 2007; SPSS Inc., Chicago, United States).
RESULTS: The mean age of the patients was 10.4 years (range: 5-15 years), with a male predominance (69.6%, n=16). Road traffic accidents (52.2%, n=12) and falls (47.8%, n=11) were the most common mechanisms of injury. Transverse fractures accounted for 56.5% (n=13) of the cases, followed by oblique fractures (39.1%, n=9). Excellent functional outcomes were achieved in 60.9% (n=14) of the patients, and good outcomes were observed in 30.4% (n=7). Complications included pin site irritation (34.8%, n=8) and superficial wound infection (17.4%, n=4), all of which were resolved with appropriate treatment. The majority of patients (52.2%, n=12) underwent K-wire removal between 12 and 14 weeks postoperatively.
CONCLUSION: Intramedullary K-wire fixation is a safe and effective treatment for unstable radial and ulnar fractures in children, with excellent functional outcomes and manageable complications. The proposed technique is particularly suitable for resource-limited settings because of its simplicity and cost-effectiveness. Future studies should explore long-term outcomes and compare K-wire fixation with other surgical techniques.