Comparative study between intramedullary K wires fixation and cast immobilization in pediatric displaced diaphyseal both bones of forearm fractures / Mostafa Aboud Aboelwafa ; Supervised Aly M. E. Elzawahry , Ihab Salah Gado , Mohamed Salama Hamdy

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Orthopedic Surgery

Background: diaphyseal forearm fractures comprise 13% of all paediatric fractures and are the second most common fracture type among adolescent. complete shaft fractures of the radius and ulna present a management challenge due to their inherent instability. successful treatment of both-bone forearm shaft fractures results in restoration of anatomic alignment and full recovery of range of motion. although closed reduction and casting is the preferred treatment method, outcomes remain variable and patients may require additional fracture manipulation or formal surgical intervention due to residual angulation and some children can be left with accepted loss of forearm rotation after conservative management due to good remodeling capacity. intramedullaryk wires fixation may be indicated if conservative treatment fails to maintain alignment, in children nearing skeletal maturity, and in open fractures.aim: the aim of this study is to compare the intramedullary k wires fixation and cast immobilisation in pediatric displaseddiaphyeal both bones fractures regarding the functional outcome,union time, redisplacement,angulation and other possible complications as malunion or nonunion. methods: we prospective analyzed 56 children with both-bone forearm fractures. 28 patients were treated with conservatively by cast immobilisation(group a), and the other 28 patients were treated withintramedullary k wires fixation (group b). the duration of surgery, times of fluoroscopy, union time, radiographic outcomes, clinical results, and postoperative complications were compared.results:there was difference in the radiographic outcomes, clinical results, the loss of forearm motion and union time between the two groups and the complication rate was significantly lower in the intramedullary k wires fixation(group b)

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