PERCUTANEOUS INTRAMEDULLARY KIRSCHNER WIRING FOR DISPLACED DIAPHYSEALFOREARM FRACTURES IN CHILDREN

Displaced fractures of the forearm in children are often treated conse rvatively, but there is a relatively high incidence of redisplacement, malunion and consequent limitation of function. We have performed per cutaneous Kirschner (K) wire fixation in 72 such children under the ag e of 14 years, of which 57 were reviewed for our study. Both the radiu s and ulna were fractured in 45 (79%), the radius only in eight and th e ulna only in four. The mean initial angulation was 19 degrees in the lateral plane and 9 degrees in the anteroposterior plane for the radi us and 15 degrees and 9 degrees, respectively, for the ulna. In 42 pat ients (74%) we performed closed reduction. In the remaining 15 (26%) c losed reduction faded and an open reduction, through a minimal approac h, was required before K wiring. At a mean follow-up of 20 months all patients had good functional results with an excellent range of moveme nt. Only five had angulation of from 10 degrees to 15 degrees and none had nonunion, premature epiphyseal closure or deep infection. Percuta neous intramedullary K wiring for forearm diaphyseal fracture is a con venient, effective and safe operation, with minimal complications.