Closed Reduction Percutaneous Intramedullary Fixation with Kirschner Wires in 4 Children with Displaced Fractures of the Distal Humerus

Background: This study describes the use of closed reduction percutaneous intramedullary fixation with Kirschner wires in 4 children with displaced metaphyseal-diaphyseal junction (MDJ) fractures of the distal humerus. Material/Methods: Between August 2016 and August 2019, 4 patients (3 boys and 1 girl), whose mean age was 4 years 5 months (range: 3 years 6 months to 5 years 4 months), with displaced MDJ fractures of the distal humerus were treated using closed reduction percutaneous intramedullary fixation with Kirschner wires. Three of the fractures were oblique and 1 was transverse. The operation time and the frequency of intraoperative fluoroscopy were recorded. All children were followed up for greater than 18 months, taking anteroposterior and lateral radiographs of the elbow joint to evaluate the outcomes. At the last follow-up, the Flynn elbow joint function score was used to evaluate clinical outcomes, and complications were recorded. Results: The mean operation time was 37.5 min (range: 35-40 min) and the frequency of intraoperative fluoroscopy was 11.7 times (range: 8-15 times). All of the fractures were confirmed to be healed based on radiographic results at 4 weeks after surgery. At the last follow-up, 4 children had normal elbow joint motion without elbow deformity. The Flynn score showed their outcomes were excellent. Conclusions: Closed reduction percutaneous intramedullary fixation using Kirschner wires was an effective treatment for displaced MDJ fractures of the distal humerus in the 4 children described and was shown to be easy to perform with a short operation time.

Automated summary

This study demonstrates that closed reduction percutaneous intramedullary fixation using Kirschner wires is an effective treatment for displaced MDJ fractures of the distal humerus in children. The procedure is easy to perform and has a short operation time, with excellent clinical outcomes and good fracture healing.