Surgical treatment of the displaced diaphyseal fractures of forearm in children : a comparative study between intramedullary Kirschner wires and plating

Abstract EN

Objective : To present the patients and the results of surgical treatment in displaced diaphyseal fracture of radius and ulna in children and to compare the result of the group treated with plate and screws with group treated by intramedullary Kirschner wire fixation.

Methods : A prospective and comparative study of operative treatment; conducted at the Department of orthopedic in ALjamhory teaching hospital, Mosul between September 2001 and May 2003.

Out of 153 children with traumatic displaced diaphyseal fracture of radius and ulna, operative treatment was indicated in 50 children, who were divided in two groups.

The first group (26 patients) was treated with fixation by intramedullary Kirschner wires (K-wires), the wire introduced from distal end of radius and from olecranon or distal end for ulna.

The second group (24 patients) was treated with fixation by 1/3-tubular plate (type AO) and screws.

The functional outcome results at last follow up were assessed clinically.

Results: There were 37 males and 13 females.

The mean follow-up was 27 months.

The mean age of patients was (10.

42) years ranged.

The right side was affected in 36 % and left side in 64 %.

The operative time and duration of hospitalization were significantly shorter in the group treated by intramedullary Kirschner wires (K-wires).

Most of the patients in both groups passed without serious complications.

About 88 % of patients in both groups had good or excellent results in last functional assessment.

Conclusion: Both intramedullary K-wires fixation and plate and screws fixation are useful techniques in the treatment of displaced diaphyseal fractures of radius and ulna.

Intramedullary K-wires fixation are safe, easy, cheaper, shorter in duration, skin incisions are smaller, less soft tissue dissection, the stripping of the periosteum is minimal, and with less complications.

The ease of K-wires removal in the outpatient clinic and no need for second operation as in plate removal is another advantage.