Lateral Condyle Fracture of the Humerus in Children: Kirschner Wire or Screw Fixation?

2020 ◽  
Author(s):  
Danielle S. Wendling-Keim ◽  
Sandra Teschemacher ◽  
Hans-Georg Dietz ◽  
Markus Lehner
Keyword(s):  
Range Of Motion ◽  
Screw Fixation ◽  
Statistical Significance ◽  
Kirschner Wire ◽  
Lower Percentage ◽  
Lateral Condyle ◽  
Fractures In Children ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Condyle Fracture

Abstract Introduction The treatment of the displaced fracture of the lateral condyle of the distal humerus in children aims not only to avoid nonunion, malalignment, and impairment of the range of motion of the elbow but also to prevent delayed healing and the development of any prearthrotic deformity. To date there is no agreement on what kind of osteosynthesis should be used. So far, the screw fixation and Kirschner wire fixation have both been applied. Therefore, the goal of this study was to compare the outcome of these two methods. Materials and Methods A retrospective cohort study was undertaken including 43 patients aged 2 to 13 years who underwent osteosynthesis for a condylar fracture of the humerus over a period of 10 years. The electronic archive, including the radiological diagnostics, was analyzed. Statistical analysis was performed using IBM SPSS Statistics 20.0. Statistical significance was set at an α level of p = 0.05. Results Kirschner wire fixation was performed in 48.9% of condylar fractures of the humerus while screw fixation (alone or in combination with a pin) was assessed with a percentage of 51.1% of the cases in this study. Screw fixation only was applied in 20.9% of fractures of the lateral condyle. The selection of the method was independent of the age of the patient (p = 0.2). The comparison of the rate of complications and an impaired range of motion after Kirschner wire osteosynthesis to the rate after screw osteosynthesis showed a significantly lower percentage for the Kirschner wire group (p = 0.046). No case of nonunion, nerve palsy, or pin migration was detected in any patient in this study. Conclusion Kirschner wire fixation of condylar humeral fractures in children resulted in a lower rate of complications than screw fixation. No case of nonunion of the fracture was found in the patients that we investigated so that we conclude that Kirschner wires sufficiently adapt the fracture in these cases. Level of Evidence Level III.

Lateral condylar fractures of the humerus in children

2018 ◽  
Vol 100-B (3) ◽  
pp. 387-395 ◽  
Author(s):  
R. Ganeshalingam ◽  
A. Donnan ◽  
O. Evans ◽  
M. Hoq ◽  
M. Camp ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Screw Fixation ◽  
Kirschner Wire ◽  
Lateral Condyle ◽  
Fractures In Children ◽  
Wire Fixation ◽  
Long Term Follow Up ◽  
Carrying Angle ◽  
K Wires ◽  
Condylar Fractures

Aims Displaced fractures of the lateral condyle of the humerus are frequently managed surgically with the aim of avoiding nonunion, malunion, disturbances of growth and later arthritis. The ideal method of fixation is however not known, and treatment varies between surgeons and hospitals. The aim of this study was to compare the outcome of two well-established forms of surgical treatment, Kirschner wire (K-wire) and screw fixation. Patients and Methods A retrospective cohort study of children who underwent surgical treatment for a fracture of the lateral condyle of the humerus between January 2005 and December 2014 at two centres was undertaken. Pre, intraoperative and postoperative characteristics were evaluated. A total of 336 children were included in the study. Their mean age at the time of injury was 5.8 years (0 to 15) with a male:female patient ratio of 3:2. A total of 243 (72%) had a Milch II fracture and the fracture was displaced by > 2 mm in 228 (68%). In all, 235 patients underwent K-wire fixation and 101 had screw fixation. Results There was a higher rate of nonunion with K-wire fixation (p = 0.02). There was no difference in Baumann’s angle, carrying angle or the rate of major complications between the two groups. No benefit was obtained by immobilizing the elbow for more than four weeks in either group. No short-term complications were seen when fixation crossed the lateral ossific nucleus. Conclusions Fixation of lateral condylar humeral fractures in children using either K-wires or screws gives satisfactory results. Proponents of both techniques may find justification of their methods in our data, but prospective, randomized trials with long-term follow-up are required to confirm the findings, which suggest a higher rate of nonunion with K-wire fixation. Cite this article: Bone Joint J 2018;100-B:387–95.

scholarly journals Functional outcome of crossed Kirschner wire fixation in pediatric supracondylar humerus fracture

2019 ◽  
Vol 5 (5) ◽  
pp. 772
Author(s):  
Rahat Zahoor Moton ◽  
Adeel Ahmed Siddiqui ◽  
Muhammad Naseem ◽  
Uzair Yaqoob ◽  
Syed Amir Jalil ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Kirschner Wire ◽  
Humeral Fractures ◽  
Treatment Modalities ◽  
Class Iii ◽  
Supracondylar Fractures ◽  
Fractures In Children ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Supracondylar Humeral Fractures

<p class="abstract"><strong>Background:</strong> Distal humeral fractures are one of the most common types of fractures in children, most of them being supracondylar. Supracondylar fractures are usually caused by trauma, most likely falls. It is an emergency, requiring rapid diagnosis and management to avoid serious complications. Recommended treatment modalities vary from no reduction and immobilization to open reduction and internal fixation. Kirschner wire (K-wire) fixation of displaced supracondylar fractures after closed reduction is a preferred method and is being performed for over 50 years now. This study was conducted to determine the functional outcome of crossed K-wire fixation in pediatric supracondylar fracture.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted from May-November 2018 at the department of Orthopedics, Abbasi Shaheed Hospital, Karachi, Pakistan. It was inferred that functional outcome of pediatric displaced supracondylar humeral fractures is satisfactory when managed with percutaneous crossed K-wire fixation. It included 83 children with supracondylar fractures. They were treated with percutaneous crossed K-wire fixation. Patients were then followed up to determine satisfactory functional outcome according to Flynn’s criteria. Data entry and analysis was done using SPSS 21.0.</p><p class="abstract"><strong>Results:</strong> Eight-three patients were included. The mean±standard deviation age of this study population was 7.03±3.39 years. Out of the study participants, 47 (56.6%) were males and 36 (43.4%) were females. 71.1% of the patients were of Gartland class II fractures and 28.9% were of Gartland class III. 43.4% had an injury due to fall while playing while 19.3% had fallen from height. 80.7% were found to have a satisfactory functional outcome.</p><p class="abstract"><strong>Conclusions:</strong> It was inferred that the functional outcome of pediatric displaced supracondylar humeral fractures is satisfactory when managed with percutaneous crossed K-wire fixation.</p>

Arthrodesis of the Interphalangeal Joint of the Hallux

2001 ◽  
Vol 91 (8) ◽  
pp. 427-434 ◽  
Author(s):  
Gerard V. Yu ◽  
Frank E. Vargo ◽  
Joel W. Brook
Keyword(s):  
Simple Technique ◽  
Functional Unit ◽  
Screw Fixation ◽  
Kirschner Wire ◽  
Interphalangeal Joint ◽  
Kirschner Wires ◽  
Effective Technique ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Common Problems

The authors present a simple and effective technique to achieve arthrodesis of the hallucal interphalangeal joint. Stabilization is achieved by external fixation with crossing Kirschner wires joined together to create a single functional unit, a technique that avoids common problems often associated with Kirschner-wire fixation. The authors propose that this simple technique be considered for patients in whom it has been determined that screw fixation should not be used to obtain fusion of the interphalangeal joint. (J Am Podiatr Med Assoc 91(8): 427-434, 2001)

Scaphoid Dislocation Reconstruction with Scapholunotriquetral Ligament Tenodesis

2021 ◽  
Author(s):  
Brian Mailey ◽  
Amanda L. Brown ◽  
James Winters
Keyword(s):  
Literature Review ◽  
Range Of Motion ◽  
Functional Outcomes ◽  
Kirschner Wire ◽  
Injury Pattern ◽  
Traumatic Injuries ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Surgical Treatments

AbstractTraumatic injuries leading to complex scaphoid dislocations are uncommon. We present a successful reconstructive case after a complex intercarpal instability injury using scapholunotriquetral tenodesis without the need for Kirschner wire fixation and early controlled range of motion therapy. At 3 months, the patient had a pain-free wrist with a 100-degree arc of motion and returned to work with full functionality. A literature review was performed to describe the previously published surgical treatments of this injury pattern and compare functional outcomes.

scholarly journals Fractures of the Zygomaticomaxillary Complex and Their Treatment: A Case Report

2016 ◽  
Vol 20 (1) ◽  
pp. 40-43
Author(s):  
Esat Bardhoshi
Keyword(s):  
Case Report ◽  
Screw Fixation ◽  
Kirschner Wire ◽  
Rigid Fixation ◽  
Facial Fractures ◽  
Titanium Plate ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Wire Osteosynthesis ◽  
Zygomaticomaxillary Complex

SummaryFractures of the zygomaticomaxillary complex are the second most common of all facial fractures. Several fixation methods have been used over the years, including wire osteosynthesis, lag screw fixation, transfacial Kirschner wire fixation, titanium plate and screw fixation, and more recently, resorbable plating system. Internal fixation with titanium plates and screw provides the most rigid fixation and thus greater immobility of the fracture segments. The degree of immobilization created with titanium plates and screws also allows fixation at fewer anatomic points.

Intramedullary Kirschner Wire Fixation of Open or Unstable Forearm Fractures in Children

1999 ◽  
Vol 19 (3) ◽  
pp. 329-337 ◽  
Author(s):  
Scott D. Shoemaker ◽  
Christopher P. Comstock ◽  
Scott J. Mubarak ◽  
Dennis R. Wenger ◽  
Henry G. Chambers
Keyword(s):  
Kirschner Wire ◽  
Forearm Fractures ◽  
Fractures In Children ◽  
Kirschner Wire Fixation ◽  
Wire Fixation

scholarly journals Comparison of radiological and clinical outcome among Kirschner wires versus 3.5 mm diameter cannulated cancellous screw internal fixation in treatment for the displaced lateral humeral condyle fractures in children

2021 ◽  
Vol 7 (2) ◽  
pp. 219
Author(s):  
Lokpal Singh Bhati ◽  
Ashish Kumar Gupta ◽  
Jitendra Singh Rathor ◽  
Devendra Singh Rathore ◽  
Deepak Kundu
Keyword(s):  
Screw Fixation ◽  
Lateral Condyle ◽  
Cancellous Screw ◽  
Kirschner Wires ◽  
Fractures In Children ◽  
High Incidence ◽  
K Wires ◽  
Condyle Fracture ◽  
Humeral Condyle ◽  
Written Informed Consent

<p><strong>Background:</strong> Lateral humeral condyle fracture, the second most common injury around the elbow, accounts for 10-20% of all fractures of the elbow in children with a high incidence between two and 14 years.</p><p><strong>Methods:</strong> This hospital based prospective randomized comparative study design was include patients of both sexes in age group of 2 to 14 years attending SMS hospital, Jaipur during April 2018 to June 2019 or till the sample size achieved, with due permission from the institutional ethic committee and review board and after taking written informed consent from the patient.</p><p><strong>Results:</strong> 40 patients out of 50 were grouped as excellent (70.1%) while 13 were found good (22.8%) and only four patients were found poor (7.01%) as per Hardacre criteria of assessment of lateral condyle treatment in k wire group while excellent, good and poor results were found 68.4, 24.5 and 7.01% respectively in CC screw groups</p><p><strong>Conclusions:</strong> The displaced fractures (displacement over 2 mm) can be treated successfully by open reduction and K-wires or screw fixation with excellent results.</p><p> </p>

scholarly journals UNSTABLE FRACTURE OF RADIUS AND ULNA

2011 ◽  
Vol 18 (02) ◽  
pp. 323-327
Author(s):  
WAQAR ALAM ◽  
FAAIZ ALI SHAH ◽  
ZAFAR DURRANI ◽  
Zahid Askar ◽  
Muhammad Ayaz Khan ◽  
...  
Keyword(s):  
Kirschner Wire ◽  
Unstable Fracture ◽  
Fractures In Children ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Ulna Fractures ◽  
K Wires ◽  
Age Range ◽  
Radiological Union

Objectives: To know the functional outcome of Intramedullary Kirschner Wire fixation of unstable Radius-Ulna fractures in children. Study Design: Descriptive study. Period: 27/03/2009 to 26/03/2010. Setting: Department of Orthopedic and Trauma, Khyber Teaching Hospital, Peshawar. Patients and Methods: All patients were admitted from OPD . Children less than 16 years with Unstable Radius- Ulna fractures were included in the study. Patients with open fractures and adults with polytrauma were excluded from the study. Unstable Radius-Ulna fractures were treated by Intramedullary Kirschner Wire fixation under general anesthesia and tourniquet control. Follow up till radiological and clinical union was done. K-wires were removed after healing of fractures. Patients were assessed functionally and radiologically and results were graded according to Price et al Criteria. Results: A total of 64 children with unstable radius and ulna fractures were included in the study. The age range was 6 to 15 years with average age of 10.41 years. 47 were male and 17 were female. The average time of radiological union was 7 weeks and K-wires were removed at 8 weeks time. At final assessment there were 47 Excellent, 10 Good and 7 Fair results. Conclusions: Excellent results can be achieved by Intramedullary K-Wires fixation. In children with unstable Radius-Ulna fractures. It should be the method of choice for treating these fractures.

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