Percutaneous K wire fixation for Paediatric monteggia fracture

Abstract Aims The aim of this study was to compare the fixation stability and complications in patients undergoing periacetabular osteotomy (PAO) with either K-wire or screw fixation. Patients and methods We performed a retrospective study to analyze a consecutive series of patients who underwent PAO with either screw or K-wire fixation. Patients who were treated for acetabular retroversion or had previous surgery on the ipsilateral hip joint were excluded. 172 patients (191 hips: 99 K-wire/92 screw fixation) were included. The mean age at the time of PAO was 29.3 years (16–48) in the K-wire group and 27.3 (15–45) in the screw group and 83.9% were female. Clinical parameters including duration of surgery, minor complications (soft tissue irritation and implant migration) and major complications (implant failure and non-union) were evaluated. Radiological parameters including LCE, TA and FHEI were measured preoperatively, postoperatively and at 3-months follow-up. Results Duration of surgery was significantly reduced in the K-wire group with 88.2 min (53–202) compared to the screw group with 119.7 min (50–261) (p < 0.001). Soft tissue irritation occurred significantly more often in the K-wire group (72/99) than in the screw group (36/92) (p < 0.001). No group showed significantly more implant migration than the other. No major complications were observed in either group. Postoperative LCE, TA and FHEI were improved significantly in both groups for all parameters (p = < 0.0001). There was no significant difference for initial or final correction for the respective parameters between the two groups. Furthermore, no significant difference in loss of correction was observed between the two groups for the respective parameters. Conclusion K-wire fixation is a viable and safe option for fragment fixation in PAO with similar stability and complication rates as screw fixation. An advantage of the method is the significantly reduced operative time. A disadvantage is the significantly higher rate of implant-associated soft tissue irritation, necessitating implant removal. Level of evidence III, retrospective trial.

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Motion and Strength Analysis of 2-Tine Staple and K-Wire Fixation in Scapholunate Ligament Stabilization in a Cadaver Model

Journal of Hand Surgery Global Online ◽

10.1016/j.jhsg.2020.12.004 ◽

2021 ◽

Vol 3 (2) ◽

pp. 67-73

Author(s):

Daniel Hess ◽

Anthony Archual ◽

Zachary Burnett ◽

Hans Prakash ◽

Emily Dooley ◽

...

Keyword(s):

Strength Analysis ◽

Scapholunate Ligament ◽

Wire Fixation

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The management of chronic paediatric Monteggia fracture-dislocation

Journal of Orthopaedics ◽

10.1016/j.jor.2021.02.009 ◽

2021 ◽

Vol 24 ◽

pp. 65-76

Author(s):

Tom Gryson ◽

Alexander Van Tongel ◽

Frank Plasschaert

Keyword(s):

Fracture Dislocation ◽

Monteggia Fracture ◽

Monteggia Fracture Dislocation

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Staged Management of Severely Displaced Calcaneal Fractures With Transarticular Pinning: A Damage Control Strategy

Foot & Ankle International ◽

10.1177/10711007211013012 ◽

2021 ◽

pp. 107110072110130

Author(s):

Kyeong-Hyeon Park ◽

Chang-Wug Oh ◽

Joon-Woo Kim ◽

Hee-June Kim ◽

Dong-Hyun Kim ◽

...

Keyword(s):

Soft Tissue ◽

Internal Fixation ◽

Kirschner Wire ◽

Wound Complications ◽

Calcaneal Fractures ◽

Simple Method ◽

Wire Fixation ◽

The Mean ◽

Radiographic Union

Background: Severely displaced calcaneal fractures can result in considerable morphology derangement and may be accompanied by soft tissue compromise. Delayed operative restoration of the calcaneal morphology may result in acute retensioning of the damaged soft tissue with associated wound-related complications. In this study, we describe a staged treatment of displaced intra-articular calcaneal fractures that uses temporary transarticular Kirschner wire (K-wire) fixation and staged conversion to definite fixation. Methods: We identified all of the patients who were treated at our institution for calcaneal fractures between 2015 and 2019. A total of 17 patients with 20 calcaneal fractures were selectively treated with 2-stage management. Temporary transarticular K-wire fixation was performed 24 hours after the injury to restore calcaneal morphology and the surrounding soft tissue. After the soft tissue was considered safe, delayed open reduction and internal fixation was performed. The time to definite surgery, radiographic alignment, wound complications, time to radiographic union, and hindfoot American Orthopaedic Foot & Ankle Society (AOFAS) scores were recorded. Results: The average follow-up period was 17 months (range, 12-43). The average Böhler angle increased from a mean of −22 degrees (range, −109 to 25) to 25 degrees (range, 0 to 47) after temporary transarticular K-wire fixation. The mean time from temporary pinning to conversion to definite internal fixation was 20 (range, 10-32) days. There were no immediate postoperative complications. The average time to radiographic union was 13.7 (range, 10-16) weeks. The mean AOFAS score was 87 (range, 55-100). No infections or wound complications were reported during the follow-up period. Conclusion: Temporary transarticular pinning for staged calcaneal fracture treatment is safe and effective in restoring the calcaneal morphology. This novel and relatively simple method may facilitate delayed operation and decrease wound-related complications. Level of Evidence: Level IV, retrospective case series.

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Ulnar Osteotomy with 2-Pin Unilateral Gradual Distraction for Treatment of Chronic Monteggia Fracture: A Case Report

Malaysian Orthopaedic Journal ◽

10.5704/moj.1703.015 ◽

2017 ◽

Vol 11 (1) ◽

pp. 79-81

Author(s):

Gooi SG ◽

Wang CS ◽

Saw A ◽

Zulkiflee O

Keyword(s):

Case Report ◽

Monteggia Fracture ◽

Ulnar Osteotomy ◽

Gradual Distraction

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Median Nerve Palsy following Elastic Stable Intramedullary Nailing of a Monteggia Fracture: An Unusual Case and Review of the Literature

Case Reports in Medicine ◽

10.1155/2011/682454 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Surjit Lidder ◽

Nima Heidari ◽

Florian Amerstorfer ◽

Stephan Grechenig ◽

Annelie M. Weinberg

Keyword(s):

Median Nerve ◽

Intramedullary Nailing ◽

Radial Head ◽

Nerve Palsy ◽

Unusual Case ◽

Elastic Stable Intramedullary Nailing ◽

Monteggia Fracture ◽

Type I ◽

Monteggia Lesion ◽

Median Nerve Palsy

Monteggia fractures are rare in children, and subtle radial head dislocations, with minor plastic deformation of the ulna, may be missed in up to a third of cases. Complications of Monteggia fractures-dislocations include persistent radial head dislocation, forearm deformity, elbow stiffness, and nerve palsies at the time of presentation. An unusual case of median nerve palsy following elastic stable intramedullary nailing of a type I Monteggia lesion in a 6-year-old girl is presented, and we highlight that, although most nerve palsies associated with a Monteggia fracture-dislocations are treated expectantly in children, early intervention here probably provided the best outcome.

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Suture Button Compared With K-Wire Fixation for Maintenance of Posttrapeziectomy Space Height in a Cadaver Model of Lateral Pinch

The Journal Of Hand Surgery ◽

10.1016/j.jhsa.2010.09.007 ◽

2010 ◽

Vol 35 (12) ◽

pp. 2061-2065 ◽

Cited By ~ 35

Author(s):

Jeffrey Yao ◽

Dan A. Zlotolow ◽

Ryan Murdock ◽

Matthew Christian

Keyword(s):

Suture Button ◽

Wire Fixation

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