Israr Ahmad, Zahid Askar, Zaffar Durani, Awal Hakim, Mohammad Idrees, Mohammad Ayaz, Imtiaz Afridi, Samad Bangash.
Intramedullary Kirchner wire fixation of unstable radius-ulna fractures in children.
Pak J Surg Jan ;23(3):208-11.

Objectives: To evaluate the results and outcome of pediatric unstable fractures of radius and ulna treated by Kirchner wire fixation. Design & Duration: Prospective quasi experimental study from July 2004 to May 2007. Setting: Department of Orthopaedics and Trauma, Khyber Teaching Hospital, Peshawar. Patients: Children with displaced fractures of both forearm bones, in whom closed manipulation had failed. Methodology: The children were treated with open reduction and internal fixation of both forearm bones with Kirchner wires (K wires). Under general anesthesia and tourniquet control the fractures were fixed by retrograde method. Patients were followed every month for clinical and radiological union of fracture and for any complications. The K wires were removed after healing of fractures. The patients were assessed for symptoms such as pain, ability to participate in physical activities or sports, and physical examination was done to see range of motion of wrist, elbow and forearm. Grading of the results was done according to modified Price criteria. Results: The total number of patients was 22. Sixteen were males and six were females. The age range was 6-12 years with an average age of 9.5 years. In most cases the middle third was involved. The average time of surgery was 65 minutes (range 50-95 minutes). The average time for clinical and radiological union was 9.2 weeks. The mean interval between the initial surgery and removal of the K wires was 3.2 months. At final assessment there were 18 excellent, two good and two fair results. Conclusion: In unstable fractures involving both forearm bones, open reduction and internal fixation (ORIF) with Kirchner wires have excellent results amongst children.

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