Treatment of femoral shaft fractures in children by intramedullary Kirschner wires.

Abstract

We present a retrospective analysis of a case series to evaluate closed intramedullary Kirschner wire (K-wire) fixation as a surgical technique in the treatment of femoral shaft fractures in children. Fifty-three femoral shaft fractures (at various levels) were fixed by using closed intramedullary K-wires. The patient was placed supine on an orthopedic traction table. Under fluoroscopic control, two K-wires (2.5-3.5 mm thick) were introduced from distal metaphysis to the proximal metaphysis, one each, from medial and lateral cortices. In three distal fractures, K-wires were inserted antegrade from the proximal to distal metaphysis through the lateral cortex. Early mobilization and weight bearing was allowed. Mean hospital stay was 6.5 days, and K-wires were removed after a mean of 5.6 months. The study included seven open fractures as well. Sound unions were achieved between 6 and 10 weeks without any significant complication. Closed intramedullary K-wire fixation for femoral shaft fractures in children is a simple surgical technique that has excellent clinical and functional results.