Failed Closed Reduction of Fracture Forearm Bones in Children The Outcome of K-Wire Fixation
AbstractThe aim of our study is to know the functional outcome of K.wire fixation for failed closed reduction of displaced forearm bones fracture in children on AL-Hussein teaching hospital of Nassiriyah city between: 1/2/2006 to 30/1/2008. It is a descriptive study for K.wire fixation of unstable fracture of radius& ulna in children less than 16 years old. The compound fractures, single bone, multiple trauma and adult patients all are excluded from this study. A eighty six (86) children were included, a sixty two ( 62 ) male & twenty four (24) female with age ranging from ( 4 to 16 ) years, with average age of( 11.21) years. The average time of radiological union and K. wire removal was 6 weeks follow by complete P.O.P cast for the average of 12 weeks to consolidation, then 3monthly follow up with physiotherapy and functional assessment for regaining of full movement up to 12 month. In the sixth month assessment there were 66(76.7%) Excellent, 14(16, 2%) Good, 6(6.9%) Fair. The final assessment in the 12th month were 86(100%) are Excellent. We conclude that the Kirschner wire intramedullary fixation followed by complete P.O.P cast and physiotherapy is the method of choice for treatment of failed closed reduction of displaced forearm bones fracture in children, in which it is safe, less invasive, less time consuming, effective, and easily performed with excellent outcome.
Abalo A, D.A., Assiobo A, Walla A, Ouderaogo A Intramedullary fixation using multiple Kirschner wires for forearm fractures: a developing country perspective. J Orthop Surg 2007; 15(3): 319-322.
Abu Hassan FO, Hand dominance and gender in forearm fractures in children. Strategies in Trauma Limb Reconstr 2008; 3(3): 101-103.
Apley’s System of Orthopaedic and Fractures Ninth Edition
Calder et al., 2003. Calder PR, Achan P, Barry M: Diaphyseal forearm fractures in children treated with intramedullary fixation: outcome of K-wire versus elastic stable intramedullary nail. Injury 2003; 34:278.
Canale & Beaty: Campbell's Operative Orthopaedics, 11th ed. Copyright © 2007 Mosby, An Imprint of Elsevier .
Celebi L, Muratli HH, Do an O, Ya murlu MF, Aksahin E,. Biçimo lu A., The results of intramedullary nailing in children who developed redisplacement during cast treatment of both-bone forearm fractures. Acta Orthop Traumatol Turc 2007; 41(3): 175-182.
Cooper C, Dennison EM, Leufkens HG, Bishop N,Vanstaa, P, Epidemiology of childhood fractures in Britain: A study using the general practice research data base. J Bones Miner Res 2004;19(12): 1976-1981.
Fernandez FF, Egenolf M., Carsten C, Holz F, SchneiderS, Wentzensen A, Unstable diaphyseal fractures of both bones of the forearm in children: plate fixation versus intramedullary nailing. Injury 2005; 36(10): 1210-1216.
Garg NK,Balal MS, Malak IA< Webster RA,Bruce CE., Use of elastic stable intramedullary nailing for treating unstable forearm fractures in children. J Trauma 2008; 65(1): 109-115.
Kalenderer O, Gurcu T, Reisoglu A, Agus H., The frequency and distribution of fractures in children presenting to the emergency service. Acta Orthop Traumatol Turc 2006; 40(5): 384-387.
Kose O, Deniz G, Yanik S, Gungor M, Islam NC., Open intramedullary Kirschner wire versus screw and plate fixation for unstable forearm fractures in children. J Orthop Surg (Hong Kong) 2008; 16(2): 165-169.
Laurer H, Sander A, Wutzler S, Walcher F, Marzi I.,Therapy principles of distal fractures of the forearm in childhood. Chirurg 2009; 80(11): 1042-1052.
L. Rennie, C. Court-Brown, J. Mok, T. Beattie., epidemiology of fractures in children. Injury 2007; 38(8): 913-922.
Mostafa MF, El-Adl G, Enan A, Percutaneous Kirschner wire fixation for displaced distal forearm fractures in children. Acta Orthop Belg 2009; 75(4): 459-66.
Ozkaya U, Parmaksizo lu AS, Kabukçuo lu Y, Yeniocak S, Sökücü S., Surgical management of unstable both-bone forearm fractures in children. Acta Orthop Traumatol Turc 2008; 42(3): 188-192
Ploegmakers JJ, Verheyen CC, Acceptance of angulation in the non-operative treatment of paediatric forearm fractures. J Pediatr Orthop B 2006; 15(6): 428-432.
Rehmani, R., Childhood injuries seen at an emergency department. J Pak Med Assoc 2008; 58(3): 114-118.
Reinhardt KR, Feldman DS, Green DW, Sala DA, Widmann RF, Scher DM. Comparison of intramedullary nailing to plating for both-bone forearm fractures in older children. J Pediatr Orthop 2008;28(4): 403-409.
Rodriquez Merchan EC, Pediatric fracture of forearm.Clin Orthop Relat Res 2005; 432:65-72.
Schmittenbecher PP, State-of-the-art treatment of forearm shaft fractures. Injury 2005; 36(11): 25-34.
Seyfettino lu F, Duygun F., Kovalak E , Ersan O, Ates B, Ates Y. Assessment of surgical and conservative treatment of forearm fractures: results in juveniles. Ulus Travma Acil Cerrahi Derg 2009; 15(4): 371-376.
Weber et al., 1980. In: Weber BG, Brunner C, Frueler F, ed. Treatment of fractures in children and adolescents, New York: Springer-Verlag; 1980