Fracture union in percutaneous Kirschner wire fixation in paediatric tibial shaft fractures

Sahu, Ramji Lal; Ranjan, Rajni

doi:10.1016/j.cjtee.2016.08.003

Cited by 8 publications

(8 citation statements)

References 35 publications

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“…K-wire was rst introduced as an internal xation implant in 1909 by Martin Kirschner and it had been used for more than 110 years in orthopedic surgery [31]. Today K-wire is commonly used as a kind of temporary xation device in clinic, however it can also been used as definitive xator in displaced metacarpal shaft fractures, clavicle fractures and paediatric tibial shaft fractures [32][33][34]. The bone marrow cavity of bula is narrow and irregular in shape, so the K-wire can be used to x bula fracture according to the principle of multi-point xation [35].…”

Section: Discussionmentioning

confidence: 99%

External fixator combined with three different fixation methods of fibula for treatment of extra-articular open fractures of distal tibia and fibula: a retrospective study

Sun

Zhou

et al. 2020

Preprint

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Background To compare the efficacy of three different fixation methods of fibula combined with external fixation of tibia for the treatment of extra-articular open fractures of distal tibia and fibula. Methods From January 2017 to July 2019, 91 cases of open fractures of distal tibia and fibula were treated with external fixator, and the fibula was fixed with non-fixation (group A, n=35), plate-screw (group B, n=30) and Kirschner wire(group C, n=26).The operation time, intraoperative blood loss, surgical and implants costs, fracture healing time, postoperative complications, and American Orthopaedic Foot and Ankle surgery (AOFAS) scores were compared among the groups. Results Four patients were lost to follow-up, and 87 patients were followed up for 5-35 months (average, 14.2 months). The operation time of group C(114.92±36.09min) was shorter than that of group A (142.27±47.05min) and group B(184.00±48.56min) (P<0.05). There was no difference in intraoperative blood loss among the three groups (P>0.05). The surgical and implants costs in group C (5.24±1.21, thousand dollars) is lower than that in group A (6.48±1.11, thousand dollars) and group B (9.37±2.16, thousand dollars) (P < 0.05).The fracture healing time of group C(5.67±1.42months) was significantly less than that of group A (6.90±1.33months) and group B(6.70±1.12months) (P<0.05). The postoperative complications such as fractures delayed union and nonunion in group C (2 cases, 8.00%) is less than that in group A (13 cases, 39.39%) and group B (11cases, 37.93%) (P<0.05). The wound infection and needle-tract infection did not differ among the three groups (P>0.05). The excellent or good rate of ankle function was 69.70% in group A, 72.41% in group B and 84.00% in group C, with no statistical difference among the three groups (P>0.05). Conclusion Compared with simple external fixator fixation and external fixator combined with plate-screw osteosynthesis, external fixator combined with K-wire intramedullary fixation shortens the operative time and fracture healing time, reduced costs and complications of fracture healing, while the blood loss, infection complications and ankle function recovery showed no difference with the other two groups. External fixator combined with plate-screw osteosynthesis had no advantage in treating extra-articular open fractures of distal tibia and fibula when compared with simple external fixation.Fund program: National Natural Science Foundation of China (11572222)

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Section: Discussionmentioning

confidence: 99%

External fixator combined with three different fixation methods of fibula for treatment of extra-articular open fractures of distal tibia and fibula: a retrospective study

Sun

Zhou

et al. 2020

Preprint

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show abstract

“…K-wire was rst introduced as an internal xation implants in 1909 by Martin Kirschner and it had been used for more than 110 years in orthopedic surgery [25]. Today K-wire is commonly used as a kind of temporary xation device in clinic, however it can also been used as de nitive xator in displaced metacarpal shaft fractures, clavicle fractures and paediatric tibial shaft fractures [26][27][28]. The bone marrow cavity of bular is narrow and irregular in shape, so the K-wire can be used to x bula fracture according to the principle of multi-point xation [29].…”

Section: Discussionmentioning

confidence: 99%

External fixator combined with three different fixation methods of fibula for treatment of extra-articular open fractures of distal tibia and fibula: a retrospective study

Sun

Zhou

et al. 2020

Preprint

View full text Add to dashboard Cite

PurposeTo compare the efficacy of three different fixation methods of fibula combined with external fixation of tibia for the treatment of extra-articular open fractures of distal tibia and fibula.MethodsFrom January 2017 to July 2019, 91 cases of open fractures of distal tibia and fibula were treated with external fixator, and the fibula was fixed with non-fixation (group A, n = 35), plate-screw (group B, n = 30) and kirschner wire(group C, n = 26).The operation time, intraoperative blood loss, surgical and implants costs, fracture healing time, postoperative complications, and American Orthopaedic Foot and Ankle surgery (AOFAS) scores were compared among the groups.ResultsFour patients were lost to follow-up, and 87 patients were followed up for 5–35 months (average, 14.2 months). The operation time of group C(114.92 ± 36.09 min) was shorter than that of group A (142.27 ± 47.05 min) and group B(184.00 ± 48.56 min) (P < 0.05). There was no difference in intraoperative blood loss among the three groups (P > 0.05). The surgical and implants costs in group C (5.24 ± 1.21, thousand dollars) is lower than that in group A (6.48 ± 1.11, thousand dollars) and group B (9.37 ± 2.16, thousand dollars) (P < 0.05).The fracture healing time of group C(5.67 ± 1.42months) was significantly less than that of group A (6.90 ± 1.33months) and group B(6.70 ± 1.12months) (P < 0.05). The postoperative complications such as fractures delayed union and nonunion in group C (2 cases, 8.00%) is less than that in group A (13 cases, 39.39%) and group B (11cases, 37.93%) (P < 0.05). The wound infection and needle-tract infection did not differ among the three groups (P > 0.05). The excellent or good rate of ankle function was 69.70% in group A, 72.41% in group B and 84.00% in group C, with no statistical difference among the three groups (P > 0.05).conclusionCompared with simple external fixator fixation and external fixator combined with plate-screw osteosynthesis, external fixator combined with K-wire intramedullary fixation shorten the operative time and fracture healing time, reduced costs and complications of fracture healing, while the blood loss, infection complications and ankle function recovery showed no difference with the other two groups. External fixator combined with plate-screw osteosynthesis had no advantage in treating extra-articular open fractures of distal tibia and fibula when compared with simple external fixation.Fund program: National Natural Science Foundation of China (11572222)

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“…Closed reduction with percutaneous Kirschner wire fixation and protection in a cast is useful for unstable, oblique fractures without comminution, 20 especially in younger children. This has been used in managing lower grade open fractures, as an alternative to external fixation.…”

Section: Treatmentmentioning

confidence: 99%

Pediatric Tibial Shaft Fractures

Patel

Horstman

Kuester

et al. 2018

IJOO

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Tibial shaft fractures are one of the most common pediatric fractures. They require appropriate diagnosis and treatment to minimize complications and optimize outcomes. Diagnosis is clinical and radiological, which can be difficult in a young child or with minimal clinical findings. In addition to acute fracture, Toddler's and stress fractures are important entities. Child abuse must always be considered in a nonambulatory child presenting with an inconsistent history or suspicious concomitant injuries. Treatment is predominantly nonoperative with closed reduction and casting, requiring close clinical and radiological followup until union. Although there is potential for remodeling, this may not be adequate with more significant deformities, thus requiring remanipulation or rarely, operative intervention. This includes flexible intramedullary nailing, Kirschner wire fixation, external fixation, locked intramedullary nailing, and plating. Complications are uncommon but include deformity, growth arrest, nonunion, and compartment syndrome.

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Fracture union in percutaneous Kirschner wire fixation in paediatric tibial shaft fractures

Cited by 8 publications

References 35 publications

External fixator combined with three different fixation methods of fibula for treatment of extra-articular open fractures of distal tibia and fibula: a retrospective study

External fixator combined with three different fixation methods of fibula for treatment of extra-articular open fractures of distal tibia and fibula: a retrospective study

External fixator combined with three different fixation methods of fibula for treatment of extra-articular open fractures of distal tibia and fibula: a retrospective study

Pediatric Tibial Shaft Fractures

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