Percutaneous K-wire fixation for femur shaft fractures in children: A treatment concepts for developing countries

Sahu, RL

doi:10.4103/2141-9248.113661

Cited by 6 publications

(4 citation statements)

References 18 publications

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“…However, rigid fixation cannot be achieved by K-wire. Further, pin infection, deformity, nonunion and joint stiffness are common when managed with K-wire [18,19].…”

Section: Discussionmentioning

confidence: 99%

How to Avoid Hand Stiffness in Metacarpal Fractures?

Noaman

Abd-Ellah

Soroor

2022

Egyptian Journal of Orthopedic Research

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Objective:The purpose of this study was to evaluate the incidence of hand stiffness and range of motion in patients with metacarpal fractures treated with internal fixation by low profile osteo-synthesis (Miniplates).Materials and methods: A prospective study including thirty-six patients with metacarpal fracture was carried out in the period between June 2018 and June 2019 at Sohag University Hospital. All these 36 patients underwent internal fixation of metacarpal fracture by mini-plates. Evaluation of pain measured on a visual analog scale (VAS), active range of motion (ROM); and grip strength and postoperative follow up is up to one year. Results: Group of patients including thirty-six patients with metacarpal bone fractures underwent internal fixation by mini plate, the mode of trauma was Motor car accident in 26 cases (72.2%) and Assault in six cases (16.7%) hitting hard objects was in 4 cases (11.1%). No complications were reported in our cases except one case (2.8%) with wound dehiscence which improved with daily dressing and good antibiotics. Conclusion: Mini-plate and screws fixation of metacarpal fractures produces anatomical reduction of fractures with stabilization that is rigid enough to allow early mobilization, thereby preventing stiffness and hence good functional results.

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“…However, rigid fixation cannot be achieved by K-wire. Further, pin infection, deformity, nonunion and joint stiffness are common when managed with K-wire [18,19].…”

Section: Discussionmentioning

confidence: 99%

How to Avoid Hand Stiffness in Metacarpal Fractures?

Noaman

Abd-Ellah

Soroor

2022

Egyptian Journal of Orthopedic Research

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“…The presence of the toggle effect in our load-deformation curves was suggestive of non-rigid fixation and may indicate secondary healing would be likely in an in vivo model. However, it is impossible to conclusively state a clinical route of physeal repair as repair is multifactorial with input of various factors ranging from fracture gap size to surrounding soft tissue contribution to fracture stability to the size of the surgical implant selected by the surgeon [ 15 ]. In our study, the decision to use Kirschner wires with a diameter of 3 mm was based on surgeon preference because definitive data on optimal pin diameter for physeal fracture stabilization are lacking.…”

Section: Discussionmentioning

confidence: 99%

A biomechanical comparison of Kirschner-wire fixation on fracture stability in Salter-Harris type I fractures of the proximal humeral physis in a porcine cadaveric model

Wang

Lovric

et al. 2017

BMC Vet Res

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BackgroundThe physis is the weakest component of immature long bones, and physeal fractures constitute about 30% of fractures in growing dogs. Fractures of the proximal humeral physis typically have a Salter Harris type I or II configuration. These fractures require accurate reduction and adequate stabilization to allow for any potential continued longitudinal bone growth, in conjunction with physeal fracture healing. Conventional internal fixation of these fractures involves insertion of two parallel Kirschner wires, although other methods described include tension band wiring, Rush pinning, and lag screws. However these recommendations are based on anecdotal evidence, and information about the biomechanical stability of physeal fracture repair is sparse. The unique anatomical structure of the epiphyseal-metaphyseal complex makes the gripping of the epiphysis for ex vivo biomechanical testing of physeal fracture repair very challenging. The objective of our study was to biomechanically assess the optimal number (three, two or one) of implanted Kirschner wires in a porcine Salter Harris I proximal humeral physeal fracture model, using motion analysis tracking of peri-fragmental retro-reflective markers while constructs were subjected to a constant axial compression and a sinusoidal torque of +/− 2 Nm at 0.5 Hz for 250 cycles.ResultsThere were significant differences between the three constructs (three, two or one Kirschner wire repair) for gross angular displacement (p < 0.001). The difference between three pins and two pins on toggle was not significant (p = 0.053), but both three-pin and two-pin fixation significantly reduced rotational toggle compared to one-pin fixation. Construct stiffness was not significantly different between any of the pin groups (p > 0.33).ConclusionsMotion analysis tracking using peri-fragmental markers in this porcine model of physeal fracture repair found that the stability at the fracture site of one-pin fixation was significantly less than two-pin and three-pin fixation. Whether there was increased stabilization of these fractures with three-pin fixation compared to two-pin fixation was not conclusive in this porcine model.

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“…Based on the concept of flexible intramedullary nails. Some authors recently advocated the use of intramedullary K-wires fixation for femoral fractures in children with encouraging results 31, 32. Nascimento et al 33 advocated flexible titanium nailing for the treatment of all diaphyseal fractures in children.…”

Section: Discussionmentioning

confidence: 99%

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

Sahu

Ranjan

2016

Chinese Journal of Traumatology

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PurposeTo evaluate the efficacy of intramedullary Kirschner wires for the treatment of unstable tibial shaft fractures in children.MethodsThis prospective study was conducted at the Department of Orthopaedic Surgery in Maharishi Markandeshwar Medical College from June 2005 to June 2010. Sixty-six children having closed fracture of the tibial shaft with a mean age of 7.7 years (range, 2–14 years) were recruited from emergency and outpatient department. They were treated with percutaneous intramedullary Kirschner wires. The clinical results of our study were rated on the basis of the criteria of union, nonunion, delayed union or malunion. All children were followed for one year.ResultsChildren achieved union in a mean time of 8 weeks (range, 6–10 weeks). Postoperatively, three children (4.55%) had delayed union, one (1.52%) valgus deformity of lower leg, three (4.55%) postoperative knee pain and twelve (18.18%) skin irritation at pin site. Wires were removed after 8–22 weeks without any complications. No patient was lost to follow-up. The results were excellent in 95.45% and good in 4.55% children.ConclusionThis technique is cost-effective, simple, quick to perform, safe and reliable and avoids prolonged hospitalization with good results.

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Percutaneous K-wire fixation for femur shaft fractures in children: A treatment concepts for developing countries

Cited by 6 publications

References 18 publications

How to Avoid Hand Stiffness in Metacarpal Fractures?

How to Avoid Hand Stiffness in Metacarpal Fractures?

A biomechanical comparison of Kirschner-wire fixation on fracture stability in Salter-Harris type I fractures of the proximal humeral physis in a porcine cadaveric model

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

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