Comparative study between intramedullary kirschner wires fixation and cast immobilisation in pediatric displaced diaphyseal both bones of forearm fractures

Hamdy, Mohamed S; Elzawahry, Aly M; Gado, Ihab S; El Wafa, Mostafa A A

doi:10.4103/eoj.eoj_7_23

Comparative study between intramedullary kirschner wires fixation and cast immobilisation in pediatric displaced diaphyseal both bones of forearm fractures

Authors

Abstract

Background
Forearm fractures involving the diaphysis are the third most frequent form of fracture in paediatrics. Conservative management is associated with higher risks of complications; therefore, the author aim to compare Kirschner (K) wire fixation with conservative management.
Methods
56 children with displaced diaphyseal ulnar and radial fractures were allocated and randomized into two groups at Kasr Al-Ainy University Hospital: the first group was managed by conservative management with cast immobilisation, and the second group was managed by K wire fixation. The primary outcomes were the degrees of postoperative ulnar and radial angulations, the required time of union, the limitation of movement degrees, and the functional outcomes. The secondary outcome was the rate of complications.
Results
K wire fixation had better significant results compared with the cast immobilisation regarding the residual radial angulation (P < 0.001), ulnar angulation degree (P < 0.001), the range of movement of forearm supination or supination (P = 0.003), and the functional outcome (P = 0.049); however, the time of union was significantly longer in the K wire group compared with the cast group (P = 0.003). Both groups were not significantly different in the complication rate (P = 0.163).
Conclusion
Cast immobilisation is safe in managing displaced diaphyseal in both bones of forearm fractures; however, K wire fixation is preferred and shows better results, especially when a good reduction cannot be achieved by conservative cast immobilisation.

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