External fixation and Kirschner wires in the treatment of paediatric displaced supracondylar femur fractures

Abstract

Purpose Kirschner-wire fixation (KF) and external fixation (EF) for the treatment of displaced supracondylar femur fractures (SFFs) were demonstrated respectively in previous reports. However, there is no paucity of convincing information on better treatment options for children. The aim of this study was to show results of KF and EF in the treatment of paediatric SFFs according to clinical and radiological outcome. Methods A retrospective analysis including 22 displaced closed SFFs was performed. A total of 12 patients were treated with KF, other ten patients were treated with EF. All patients were followed up for at least 24 months. Demographic data, surgical outcomes and postoperative knee function using the Knee Society Score (KSS) scale were evaluated in this research. Results The patients in the KF group were significantly younger than in the EF group (p < 0.001). The KF group had superiority in operative time (p = 0.001), blood loss (p = 0.027) and length of hospital stay (p = 0.001). Clinical healing outcome did not differ between the two groups. The KF group achieved radiological union in a shorter period (p < 0.001), with a better range of movement (ROM) and KSS postoperative score. Conclusion Both KF and EF can achieve excellent outcomes for paediatric SFFs. KF has many advantages in younger children. Level of Evidence IV

Treatment of pediatric femur supracondylar fractures: comparison of K-wire fixation versus plate-screw fixation

“…Splints, fixation with K-wires, plate-screw applications, and external fixation methods can be used for the treatment of these fractures. Criteria such as providing and maintaining anatomical reduction, normalization of joint movements, reducing the risk of complications, minimal damage, and good results are important in the selection of the ideal treatment [8].…”

“…Of all patients, follow-up period, age, fracture union time, gender, leg length difference, and Knee Society Score (KSS) data were analyzed. KSS, which has been first used in adult arthroplasty patients, has also been used to evaluate postoperative functional outcomes in pediatric cases over time [8,11].…”

“…has also been used to evaluate postoperative functional outcomes in pediatric cases over time [8,11].…”

“…Although these methods have biomechanical advantages and disadvantages compared to each other, the fact that the patients are children has prevented the comfortable use of all implants because the growth plates continue the growth of the extremity. For this reason, studies conducted have indicated that K-wires and external fixator treatment are effective [8]. On the other hand, the necessity of rigid fixation and preservation of the physical line in the treatment of fractures may be potential disadvantages of using K-wire or titanium elastic nails [4,9].…”

Displaced supracondylar femoral fractures: Clinical and radiographic outcomes in children aged 4–10 years treated with Kirschner wires and hip spica cast

“…Numerous variables influence the decision to fixate, including the age and size of the child, associated injuries, location and pattern of the fracture, and social situation of the child (3)(4)(5). Kirschner wires (K-wires), as a less invasive technique, have been reported for the treatment of displaced SFFs in younger patients (3,6), but whether this treatment can be safely used in older patients remains uncertain. This study's primary goal was to retrospectively assess the clinical and radiographic outcomes of displaced SFFs treated with K-wires and hip spica cast.…”