K-wire Fixation of Unstable Fracture of Both Forearm Bones in children: Comparison with Plate Fixation

Kim, Woo Il; Choi, Ik Soo; Lim, Sung; Kim, Do Hyung

Abstract

The fractures of the both forearm bones are extremely common in children. Between the radius and ulna, there is normally through an arc of 180° rotation. To restore full rotation, rotational deformity and angulation after fracture must be corrected. The goal of treatment of the unstable forearm fracture is to increase the function of the forearm and hand as well as to get solid bone union. The general principle of treatment of forearm fracture in children is conservative due to remodeling and spontaneous correction ability. Thus, most fractures at any level need not and should not be treated by open reduction and internal fixation. But the operation will be perform frequently who shortly before maturity. We reviewed twenty-three children between 8-13 age, who had dsiplaced both forearm bones fracture, and who were treated with fixation using K-wire(14 cases) or plate(9 cases). Of the twenty-three fractures, sixteen were unsatisfactory reduction with more than 10° of angulation after initial closed reduction, two were loss of reduction in cast immobilization, and five were internally fixed primarily because of soft tissue interposition between fragment. The results were as follows. l. Operation time was 51.4 minutes in K-wire group and 86.7 minutes in plate group. 2. Bone union occured in all cases, at 7.3 weeks in K-wire fixation group and 8.9 weeks in plate fixation group. And immobilization period 7 weeks in K-wire fixation group and 4 weeks in plate fixation group. 3. Functional results were satisfactory all cases in both group. 4. The advantage of K-wire is a simple safe operation with minimal morbidity and small scar and compares with the extensive approach need for plate fixation which often giving a poor cosmetic result. Moreover, a second operation, with significant morbidity, is need to remove the plate after solid union. In Conclusion, this method is a favorable altenative to plate fixation of children forearm fractures. It allows rapid bone union with minimal morbidity, complication and scar.