Percutaneous Kirschner wire (K-wire) fixation for humerus shaft fractures in children: A treatment concept

Abstract

Background:Fractures of the humeral shaft are uncommon, representing less than 10 percent of all fractures in children. Humeral shaft fractures in children can be treated by immobilisation alone. A small number of fractures are unable to be reduced adequately or maintained in adequate alignment, and these should be treated surgically. In the present study, Kirschner wires (K-wire) were used to achieve a closed intramedullary fixation of humeral shaft fractures. The objective of this study was to evaluate the efficacy of intramedullary K-wires for the treatment of humeral shaft fracture in children.Patients and Methods:This prospective study was conducted in the Department of Orthopaedic surgery in M. M. Medical College from June 2005 to June 2010. Sixty-eight children with a mean age of 7.7 years (range, 2-14 years) were recruited from Emergency and out patient department having closed fracture of humerus shaft. All patients were operated under general anaesthesia. All patients were followed for 12 months.Results:Out of 68 patients, 64 patients underwent union in 42-70 days with a mean of 56 days. Complications found in four patients who had insignificant delayed union which were united next 3 weeks. Intramedullary K-wires were removed after an average of 5 months without any complications. The results were excellent in 94.11% and good in 5% children.Conclusion:This technique is simple, quick to perform, safe and reliable and avoids prolonged hospitalization with good results and is economical.

Evaluation of upper extremity function of displaced diaphyseal humeral fractures in children treated by elastic stable intramedullary nailing: preliminary results

“…Similarly, Qidwai [12] reviewed 29 humeral shaft fractures in adolescents and adults (range: 14-60 years) treated by closed fixation with multiple intramedullary Kirschner wires. Both studies reported the technique to be simple, quick to perform, safe, and reliable in providing stable fixation, mostly in transverse and short oblique fractures of the humeral shaft [11,12]. Garg All values except translation are expressed in degrees (mean SD).…”

“…Sahu [11] reviewed a group of 68 children aged between 2 and 14 years old presenting a closed fracture of the humeral shaft and found that 64 fractures were treated with Kirschner wires that were used to achieve a closed intramedullary fixation. Similarly, Qidwai [12] reviewed 29 humeral shaft fractures in adolescents and adults (range: 14-60 years) treated by closed fixation with multiple intramedullary Kirschner wires.…”

“…Surgical options include the use of ESIN, Kirschner wires, external fixation, or screw and plate fixation [2,[10][11][12].…”

“…Moreover, the ESIN technique is minimally invasive, easy to learn, and has a low complication rate [1,7,10]. However, although the technique originally described by Ligier and colleagues is used widely, none of the published studies dealing with surgical management of humeral shaft fractures in children have evaluated the clinical and radiological outcomes of treatment using ESIN [2,7,[10][11][12].…”

“…However, the indications and the type of surgical treatment remain controversial issues in the literature [2,3,5,10,[11][12][13].…”