Noor Akbar Sial, Muhammad Javaid Iqbal, Muhammad Kaleem Shaukat.
Outcome of Open Reduction and Intramedullary Kirschner-Wires Fixation for Fracture Shaft Radius Ulna in Children.
Annals Punjab Med Coll Jan ;5(2):89-94.

Background: There has been a trend toward operative management of pediatric Diaphyseal Forearm Fractures (DFFx). We studied our experience with surgical management of these injuries to assess outcome and complications. Objective: The purpose of this study was to assess outcome and complications associated with open reduction and intramedullaryKirschner-wire fixation for fracture shaft radius ulna in children. Design: Prospective study. Setting: Orthopedic surgery departments of Independent Medical College, Punjab Medical College and University Medical College Faisalabad. Study Period: Between March 2009 and February 2011. Method: The study group included 32 boys and 12 girls aged 6-15 years with unstable displaced fractures shaft radius, ulna or both.  Relevant history and x-rays of the forearm were taken. We followed the inclusion and exclusion criteria.  All the cases were treated with open reduction and retrograde Kirchner wire fixation.  The cases were followed for at least 6 months. Patients were assessed functionally and radiologically and results were graded according to the system described by Price et al as excellent, good, fair and poor. Results:  This prospective study was completed on 44 patients 32 were male and 12 were female.  All fractures were united in acceptable alignment. At final assessment there were 30 (68.18%) excellent, 8 (18.18%) good, 3 (06.82%) fair and 3 (06.82%) poor results. The fair or poor clinical outcome was higher in children above 10 years of age. Delayed union after IM intramedullary fixation occurred in 3 children over 10 years of age. Conclusion: This technique can provide precise fracture reduction, maintains stabilization for fracture healing, results in minimal cosmetic deformity, cost effective and facilitates easy removal of implants after treatment.

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