INTRAMEDULLARY KIRCHNER WIRES FIXATION IN UNSTABLE RADIUS AND ULNA FRACTURES IN CHILDREN, IN A TERTIARY CARE HOSPITAL

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Syed Dil Bagh Ali Shah
Muhammad Jamil
Sameer Khan Kabir
Muhammad Ayaz Khan
Sikandar Hayat
Aqil Muhammad

Abstract

Objective: To assess outcome of pediatric unstable radius and ulna fracture fixation with intra-medullary k-wires
Material and Methods: This prospective observational study was performed over a period of 38 months from June 2014
to Aug 2017 at department of Trauma & Orthopedics Khyber Teaching Hospital Peshawar-Pakistan. Study comprised
of the children with displaced fracture of both the forearm bones i-e Radius and Ulna, treated with Open reduction and
internal fixation with Kirchner wires. Under General anesthesia and tourniquet control first radius was fixed with Kirchner
wire and then ulna, both in a retrograde manner. Wounds were closed, back slab applied for a short duration of 02-03
weeks and then patients were followed for clinical and radiological union of the fractures on a regular basis in O.P.D.
k-Wires removed on consolidation of fractures .Patients were assessed for pain, ability to participate in their activities
according to their age and physical examination was performed to assess range of movements at elbow, wrist and
forearm (pronation-supination).Modified Flynn criteria were used to grade the outcome.
Results: The total number of patients was 33.Twenty two(61%) were male while 13 (39%)were females. Majority of the
patients 25 (76%) were of the age less than 10 years. 31 (94%) patients suffered from fracture due to a fall. Majority
of the children 19 (58%) suffered from Right forearm fracture. Only 04 (12%) patients had superficial wound infection.
31(94%) patients healed satisfactorily while 02 (6%) patients end up with non-union. 01 (03%) patient needed bone
grafting along with plate osteosynthesis. At the end, excellent results were achieved in 91%, good in 7% and fair in 2%
(modified Flynn criteria). On average the mean interval between initial surgery and removal of K-Wire was 03 months.
Incidence of re-fracture after K-Wires removal was nil.
Conclusion: Unstable forearm fractures in children treated with Open reduction and Kirchner wires fixation have good
to excellent outcome

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