Ali Ahmad, Mohammad Asif Qureshi, Zain Ali.
Pin tract infection rates between percutaneous and buried k-wires in supracondylar fracture of humerus in children.
Pak J Surg Jan ;26(2):146-50.

Objective: To compare pin tract infection rate between percutaneous and buried Kirschner wires (K-wires) in supracondylar fracture of humerus in children. Study Design: A retrospective study. Setting and Duration: Department of orthopaedics, Hamdard College of Medicine and Dentistry, Karachi and department of orthopaedics, Karachi Medical and Dental College, Karachi from January 2005 to October 2009. Methodology: Out of 154 patients of Gartland type – III, Supracondylar fracture of humerus, 66 patients were treated by percutaneous K-wire fixation and 88 by buried K-wires. The data of above mentioned children was collected on proforma and analyzed. Results: In this study 13 wires out of 66 wires in percutaneous K-wire group has developed infection in comparison to only 2 wires out of 88 K-wires in buried K-wire group. Th is difference was statistically signifi cant (p < 0.001). Other wound related complications found in this study were overgranulation in 5 patients, hypersensitive scar in 1 patient, neuroparaxia in 1 patient, wire loosening in 16 patients and retromigration in 5 patients. Th ere was no fatal complication resulting from antegrade migration of K-wires. Conclusion: It is evident from this study that Kirschner wires, that were left exposed percutaneously in the fixation of supracondylar fracture of humerus in children, have a significantly higher pin tract infection rate than those that were buried beneath the skin. The advantages of burying the K-wires are less incidence of infection and lower risk of early removal of an infected K-wire and subsequent displacement of fracture fragments, but the disadvantage of burying K-wires in paediatric population is that it will need to be removed as a day case surgery with considerable financial implications.

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