scholarly journals Management of Pediatric Displaced Distal Metaphyseal Forearm Fracture: Comparison between Cast Immobilization and Percutaneous Kirschner Wire Fixation

2013 ◽  
Vol 2 (1) ◽  
pp. 1-6
Author(s):  
D Shrestha ◽  
D Dhoju ◽  
N Parajuli ◽  
G Dhakal ◽  
R Shrestha
Keyword(s):  
Clinical Outcomes ◽  
Closed Reduction ◽  
Forearm Fracture ◽  
Kirschner Wire ◽  
Cast Immobilization ◽  
Kirschner Wire Fixation ◽  
Group I ◽  
Alternative Treatment Option ◽  
Wire Fixation ◽  
Group Ii

Background: Distal metaphyseal forearm fracture is one of the common injuries in children. Closed reduction and above elbow cast is the standard method of treatment but reported to be associated with redisplacement rate of 7-25%. Closed reduction and fixation with percutaneous Kirschner wire is an alternative treatment option to prevent redisplacement. Methods: Thirty five children (group I) of age between 6 to 13 yrs with displaced ( more than 50% of cortical diameter) or angulated (more than 20°) distal metaphyseal forearm fracture managed with closed reduction and above elbow cast were compared with 21 children (group II) managed with closed reduction and percutaneous crossed Kirschner fixation. Clinical outcomes and complications were compared in both groups after 12 weeks of follow up. Results: Preoperative variables in both the groups were comparable. Mean loss of elbow flexion and extension (12° vs. 4°, p =0.08), wrist dorsflexion and palmerflexion (27° vs. 14°, p=0.12) and forearm supination and pronation (27° vs. 15°, p= 0.143) were more in group I but were statistically not significant. Complications rate (28.4% vs. 19.04%, p= 0.04) was higher in group I (such as fracture redisplacement and swelling) than in group II (pin tract infection). Conclusions: Grossly displaced or angulated distal metaphyseal forearm both bone fracture in children treated with either closed reduction and above elbow cast or closed reduction with crossed Kirschner wire fixation have no statistically significant clinical outcomes in terms of loss of movement of elbow, wrist and forearm but complication rate is higher in cast group. Percutaneous Kirschner wire fixation prevents redisplacement. DOI: http://dx.doi.org/10.3126/noaj.v2i1.8133 Nepal Orthopaedic Association Journal Vol.2(1) 2011: 1-6

Outcome of Proximal Chevron Osteotomy for Hallux Valgus With and Without Transverse Kirschner Wire Fixation

2008 ◽  
Vol 29 (11) ◽  
pp. 1101-1106 ◽  
Author(s):  
Keun-Bae Lee ◽  
Chang-Young Seo ◽  
Chang-Ich Hur ◽  
Eun-Sun Moon ◽  
Jae-Jun Lee
Keyword(s):  
Hallux Valgus ◽  
Kirschner Wire ◽  
Kirschner Wires ◽  
Fixation Group ◽  
Chevron Osteotomy ◽  
Kirschner Wire Fixation ◽  
Group I ◽  
Wire Fixation ◽  
Group Ii ◽  
Severe Hallux Valgus

Background: Proximal chevron osteotomy (PCO) for hallux valgus is inherently more stable than the other forms of proximal metatarsal osteotomy, but complications, such as, delayed union, nonunion, and malunion can occur. In this study, we have compared results of two axial Kirschner wire fixation with or without transverse Kirschner wires in PCO for moderate to severe hallux valgus deformities. Methods: A prospective study was conducted on 65 patients (85 feet) that underwent PCO and a distal soft tissue procedure for moderate to severe hallux valgus. Patients were divided into two groups, two axial Kirschner wire fixation (Group I) and two axial and supplementary transverse Kirschner wire fixation (Group II). Group I comprised 41 feet of 32 patients and Group II 44 feet of 33 patients. Results: Average AOFAS scores were 52.8 points in group I and 49.6 points in group II preoperatively, and 92.8 and 89.6 points, respectively, at last followup. Patients were very satisfied or satisfied in 92.7% in Group I and 93.2% in Group II. Average hallux valgus angles in Groups I and II changed from 34.9 degrees and 37.2 degrees preoperatively to 12.3 degrees and 13.9 degrees postoperatively, and intermetatarsal angles in Groups I and II changed from an average of 17.9 degrees and 17.2 degrees preoperatively to 10.3 degrees and 10.4 degrees postoperatively. No significant inter-group differences were found. Conclusion: Supplementary transverse Kirschner wire fixation is not recommended for proximal metatarsal chevron osteotomy since two axial Kirschner wires provided sufficient stability. Level of Evidence: I, Prospective Radomized Study

scholarly journals Closed Reduction and Percutaneous Kirschner Wire Fixation Combined with Plaster Cast versus Conventional Plaster Cast immobilization in the Treatment of Colles' Fracture – A Prospective Randomized Comparative Study

1970 ◽  
Vol 17 (2) ◽  
pp. 98-105 ◽  
Author(s):  
KS Uzzaman ◽  
KA Awal ◽  
MK Alam
Keyword(s):  
Comparative Study ◽  
Closed Reduction ◽  
Kirschner Wire ◽  
Plaster Cast ◽  
Cast Immobilization ◽  
Fixation Group ◽  
Wire Fixation ◽  
Colles Fracture ◽  
End Results

Purpo'e: To evaluate functional & anatomical results of the Colles’ fracture treated by two methods- i) Closed reduction & precutaneous kirschner wire (K- wire) fixation combined with plaster cast & ii) Conventional plaster cast immobilization after closed reduction.Methods: A randomized prospective comparative study was done from July 2003 to June 2005 on 52 patient with Colles' fracture in NITOR, Dhaka. 12 patients lost from follow up. Twenty patient (20) in each group were finally available for evaluation. The group treated by closed reduction & percutaneous K-wire fixation combined with plaster cast- designated as "Arm A" & another group treated conventionally by plaster cast only designated by "Arm-B". Male Female ratio was 1:3, Age range was 35 to 70 years (Mean age 52.5 years) Distribution of limbs side involvement almost equal. Mode of injuries were domestic fall & RTA (4:1) According to AO classification fracture were in both groups- A2 = 13, A3 = 10, C1 = 6, C2 = 8 & C3 = 3 (Total- 40). Follow up period was 6-14 months (mean = 6 month)Results: Union time for most of the fractures was 6-8 weeks. At final follow up Satisfactory Anatomical end results of percutuneous fixation group (Arm-A) were 80% and in conventional plaster cast group (Arm-B) were 35%. (P<0.01). Satisfactory functional end results in Arm-A group were 70% and in Arm-B group were 30% (P<0.01) Complications seen much more in conventional group (Arm-B) than percutaneous K-wire fixation group (Arm-B). Sarmiento & Latta’s criteria was used to evaluate the progress.Conclusion: The coventional plaster cast method for treatment of colles’ fracture usually can't maintain radial length & angulation in many instances and results significant anatomical difficultly and functional disability. On the other hand after close reduction additional fixation in the form of percutaneous crossed K-wire can maintain the reduction till bony union & prevent late collapse at fracture site & provides better result. Key Words: Colles' fracture; closed reduction; Plaster cast & Kirschner wire (K-wire) fixationDOI: 10.3329/jdmc.v17i2.6591J Dhaka Med Coll. 2008; 17(2) : 98-105

Double Dislocation of the Fifth Metacarpal

1995 ◽  
Vol 20 (2) ◽  
pp. 253-254 ◽  
Author(s):  
C. KHODADADYAN ◽  
R. HOFFMANN ◽  
Y. MOAZAMI-GOUDARZI ◽  
N. P. SÜDKAMP
Keyword(s):  
Closed Reduction ◽  
Kirschner Wire ◽  
Metacarpal Bone ◽  
Kirschner Wire Fixation ◽  
Wire Fixation

A case of traumatic, simultaneous, double dislocation of the fifth metacarpal bone is presented. Closed reduction was easily achieved and held with transarticular, crossed Kirschner wire fixation.

scholarly journals Retrospective analysis of Intramedullary K-Wire fixation of Metacarpal Fractures

2021 ◽  
Vol 7 (2) ◽  
pp. 22-27
Author(s):  
Dr. Sunil Kumar Kirar ◽  
◽  
Dr. Sanjay Upadhyay ◽  
Dr. Sanat Singh ◽  
Dr. Atul Varshney ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Kirschner Wire ◽  
Functional Results ◽  
Clinical Results ◽  
Metacarpal Fractures ◽  
Kirschner Wire Fixation ◽  
Metacarpal Bones ◽  
Flexion Extension ◽  
Wire Fixation ◽  
K Wires

Introduction: The majority of fractures of the metacarpal bones occur at a young age.Most of thetimes these metacarpal fractures can be treated conservatively in a POP slab(cock up slab)producing good functional results.Surgery was indicated in patients with palmar dislocation of >30°and shortening of >5 mm.Our study aimed to evaluate the clinical results of all metacarpal fracturestreated surgically by intramedullary Kirschner-wire fixation presented in our hospital.Materials andMethods: It was a retrospective study in which we included 50 patients with metacarpalfractures(both open andclosed) that came in our hospital, treated surgically by closed reduction andwere fixed with two intramedullary k-wires. Result: K-wires were removed after 4 weekspostoperatively,under local anaesthesia in the OPD. Metacarpal joint functions (flexion, extension,rotation) were clinically followed up in all patients, on the median periodof6 months (3 months to 9months). In our study, we found in all patients,flexion and extension were normal on bothsides.Conclusion: Closed reduction and intramedullary k-wire fixation of metacarpal bone fracturesproduce good functional results in the longterm. We found a very low rate of complication and thusrecommendthis surgical method for the stabilization of all these types of fractures.

scholarly journals Treatment of slipped capital femoral epiphysis - a comparative study during twelve years period

2019 ◽  
Vol 147 (5-6) ◽  
pp. 335-340
Author(s):  
Bojan Bukva ◽  
Sinisa Ducic ◽  
Vladimir Radlovic ◽  
Goran Vrgoc ◽  
Branislav Krivokapic ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Closed Reduction ◽  
Statistical Significance ◽  
Slipped Capital Femoral Epiphysis ◽  
Cannulated Screw ◽  
Cast Immobilization ◽  
Group I ◽  
Before And After ◽  
Group Ii ◽  
Screw Group

Introduction/Objective. The purpose of this study was to compare two methods of treatment and to evaluate the advantages in the final outcome of transcervical fixation of the femoral head using one cannulated screw in the treatment of slipped capital femoral epiphysis. Methods. This study included 65 pediatric patients (35 boys and 30 girls), aged 6?16 years (average 11.86), during a 12-year period (2000?2012). We compared the slipping degree before and after the treatment (Southwick angle), the range of motion before and after treatment, and complication occurrence between two groups of children. The first group of children (26 patients) underwent closed reduction and cast immobilization (Group I). The other group (39 patients) was treated with transcervical fixation using one cannulated screw (Group II). Results. Comparing preoperative and postoperative Southwick angle, we found much better improvement in Group II, but without statistical significance between the two groups of patients (p = 0.09). Observing the range of motion of the hips before and after treatment, we found improvement in both groups of patients, especially in patients treated using transcervical fixation with cannulated screw (Group II). In complication occurrence, the patients in Group II had less complication occurrence compared to Group I (p = 0.02). Conclusion. The transcervical fixation using one cannulated screw has better clinical outcome and lower complication rate in relation to closed reduction and cast immobilization in the treatment of slipped capital femoral epiphysis.

Juxta-Epiphyseal Fractures of the Base of the Proximal Phalanx of the Fingers in Children and Adolescents

2002 ◽  
Vol 27 (1) ◽  
pp. 24-30 ◽  
Author(s):  
M. M. AL-QATTAN
Keyword(s):  
Children And Adolescents ◽  
Closed Reduction ◽  
Kirschner Wire ◽  
Proximal Phalanx ◽  
Fracture Site ◽  
Pattern Of Injury ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Epiphyseal Fractures

A series of 34 juxta-epiphyseal fractures of the base of the proximal phalanx of the fingers of children and adolescents are presented. The pattern of injury appeared identical in all these fractures, with a lateral angulation force separating a small triangular metaphyseal fragment from the base of the phalanx on the side of angulation and the fracture line then continuing through the metaphysis, 1–2mm distal to the growth plate. Fractures were classified into two types according to the degree of displacement. Type 1 fractures ( n=18) were mildly displaced and were all successfully treated with closed reduction and splinting. Type 2 fractures ( n=16) were severely displaced and problems with obtaining an adequate reduction and long-term residual deformities were encountered. One patient with a severely displaced fracture required open reduction and Kirschner-wire fixation because of flexor tendon entrapment at the fracture site. Another five cases required Kirschner-wire fixation after closed manipulation in order to maintain the reduction. The remaining 10 patients with Type 2 fractures were treated by closed reduction and splinting, and two patients healed with malunion causing a “pseudo-claw” deformity.

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