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

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 (۴۲ boys and ۱۶ 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 ۸.۹ months (۶-۱۲).Results: The mean age of the patients was ۷.۴ years (۴-۱۲). More than ۲/۳ of the fractures were in the right hand. Around ۶۳% of the fractures were in the middle third, ۲۸% in the distal third, and ۹% in the proximal third. Moreover, ۱۲% were open type I Gustilo-Anderson fractures. The mean time from injury to surgery was two days (۱-۴), and the mean length of hospital stay was ۲.۸ days (۲-۵). The mean duration of surgery was ۲۴.۷ minutes (۱۸-۳۸), and the mean follow-up time was ۸.۹ months (۶-۱۲). All fractures united within ۴-۱۶ weeks (mean: ۷.۶۲). 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 (۵%), all controlled by antibiotics and timely removal of the pins. Mild restriction of elbow extension (less than ۲۰ degrees) was observed in three cases, which returned to normal at the last follow-up. Limitation of dorsiflexion of the wrist by more than ۲۰° occurred in two patients (۳۵° and ۴۵°), which reverted to ۲۵° and ۲۵°, 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 ۴-۱۲ years. Level of evidence: IV

Keywords:

Both bones , forearm , intramedullary fixation , Kirschner wire , Radius