Turkish journal of medical sciences · 2026
Timing of Kirschner wire removal in pediatric supracondylar humerus fractures: Is early removal a safe and effective option?
СтатьяНазвание и аннотация: Перевод в очереди
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Yenidünya Mustafa Kemal, Yüksel Sinan, Adigüzel İbrahim Faruk, Dinç Serhat, Ersan Önder
Аннотация
BACKGROUND/AIM: The optimal timing of Kirschner wire removal following the surgical treatment of pediatric supracondylar humerus fractures remains controversial. This study aimed to compare the clinical and radiographic outcomes of early versus late K-wire removal and to contribute to the standardization of the timing of pin removal in pediatric patients.
MATERIALS AND METHODS: This retrospective study included 90 pediatric patients (aged 4-14 years) treated with closed reduction and percutaneous pinning for Gartland type III and IV supracondylar humerus fractures. Patients were grouped according to the timing of pin removal as early (postoperative days 21-28, n = 40) or late (after postoperative day 28, n = 50). Clinical outcomes were evaluated in the early postoperative period and at 6 months using the Mayo Elbow Score and Flynn criteria, whereas radiographic assessments at 6 months included the Baumann angle and lateral rotation percentage. Age-based subgroup analyses were performed for patients aged ≤8 years and >8 years.
RESULTS: At 6 months, the Baumann angle did not differ between groups, whereas lateral rotation percentage was significantly lower in the early removal group (p = 0.03). Overall clinical outcomes were similar between the early and late removal groups. In subgroup analyses, patients aged ≤8 years showed significantly better early postoperative Mayo Elbow Score and Flynn criteria results after early pin removal (p < 0.05), whereas no differences were observed in older patients. Clinical outcomes at 6 months were comparable across all groups.
CONCLUSION: Early and late K-wire removal result in comparable midterm clinical and radiographic outcomes. In younger children, early pin removal after adequate stability and radiographic union have been achieved appears to be a safe and feasible option that does not compromise clinical outcomes and may reduce the need for prolonged radiographic follow-up.
MATERIALS AND METHODS: This retrospective study included 90 pediatric patients (aged 4-14 years) treated with closed reduction and percutaneous pinning for Gartland type III and IV supracondylar humerus fractures. Patients were grouped according to the timing of pin removal as early (postoperative days 21-28, n = 40) or late (after postoperative day 28, n = 50). Clinical outcomes were evaluated in the early postoperative period and at 6 months using the Mayo Elbow Score and Flynn criteria, whereas radiographic assessments at 6 months included the Baumann angle and lateral rotation percentage. Age-based subgroup analyses were performed for patients aged ≤8 years and >8 years.
RESULTS: At 6 months, the Baumann angle did not differ between groups, whereas lateral rotation percentage was significantly lower in the early removal group (p = 0.03). Overall clinical outcomes were similar between the early and late removal groups. In subgroup analyses, patients aged ≤8 years showed significantly better early postoperative Mayo Elbow Score and Flynn criteria results after early pin removal (p < 0.05), whereas no differences were observed in older patients. Clinical outcomes at 6 months were comparable across all groups.
CONCLUSION: Early and late K-wire removal result in comparable midterm clinical and radiographic outcomes. In younger children, early pin removal after adequate stability and radiographic union have been achieved appears to be a safe and feasible option that does not compromise clinical outcomes and may reduce the need for prolonged radiographic follow-up.