Clinical Study Of Closed Reduction And Intramedullary Fixation With K-wire In The Treatment Of Pediatric Mid-shaft Both Bone Forearm Fractures

Objective:To analyze the clinical efficacy of closed reduction and K-wire intramedullary fixation for mid-shaft both bone forearm fractures in children by respectively comparing with closed reduction and ESIN(Elastic Stable Intramedullary Nailing)intramedullary fixation and closed reduction and small splint immobilization.Methods:The clinical data of 79 children with mid-shaft both bone forearm fractures were retrospectively analyzed in the Department of Orthopaedics of the Affiliated Hospital of Southwest Medical University from July 2017 to September 2019.All patients were divided into group A(21 cases),B(30 cases)and C(28 cases).In group A,all cases were treated with closed reduction and K-wire intramedullary fixation;in group B,all cases were treated with closed reduction and ESIN intramedullary fixation;in group C,all cases were treated with closed reduction and small splint immobilization.There were 16 males and 5 females in group A,with an average age of(7.62±0.97)years;20 males and 10 females in group B,with an average age of(7.57±1.41)years;18 males and 10 females in group C,with an average age of(7.71±1.36)years.The general data,treatment cost,bone union time and complications of the three groups were compared,as well as the operation time and hospitalization time of group A and group B.At the last follow-up,Anderson scoring standard was used to evaluate the treatment effect of all patients and the excellent rate of three groups were compared.2.Results:All cases were followed up for 6-13 months,with an average of(9.03±2.21)months.There were no significant differences in general information(gender,age)between the three groups of patients before treatment(P>0.05).Group B had the highest treatment cost,and group C had the lowest treatment cost,the difference between the three groups was statistically significant(P<0.05).There was no significant difference in bone union time between the three groups(P>0.05).No complications such as infection,delayed union and nonunion,osteofascial compartment syndrome(OCS)and refracture happened in this study.8 cases in group C had redisplacement of fracture that needed rereduction.and there were no complications happened in group A and group B.There was no significant difference in operation time and hospitalization time between A and B group(P>0.05).At the last follow-up,the excellent rate of group A was 95.24%,96.67% of group B and 78.57% of group C.The difference of excellent rate among the three groups was statistically significant(P< 0.05).Furtherly,there were no statistical differences between group A and group B(P>0.05),while group C were compared with group A and group B,differences have statistical significance(P<0.005).Conclusion:Closed reduction and K-wire intramedullary fixation for pediatric mid-shaft both bone forearm fractures provides reliable fixation and good forearm function recovery,has a lower incidence of complications compared with small splint immobilization,and lower treatment cost compared with ESIN intramedullary fixation.It is an effective and economical treatment,which is worthy of clinical promotion.