title: Closed reduction and K-wiring with the Kapandji technique for completely displaced pediatric distal radial fractures.
abstract: In completely displaced pediatric distal radial fractures, achieving satisfactory reduction with closed manipulation and maintenance of reduction with casting is difficult. Although the Kapandji technique of K-wiring is widely practiced for distal radial fracture fixation in adults, it is rarely used in pediatric acute fractures. Forty-six completely displaced distal radial fractures in children 7 to 14 years old were treated with closed reduction and K-wire fixation. One or 2 intrafocal K-wires were used to lever out and reduce the distal fragment's posterior and radial translation. One or 2 extrafocal K-wires were used to augment intrafocal fixation. Postoperative immobilization was enforced for 3 to 6 weeks (with a short arm plaster of Paris cast for the first half of the time and a removable wrist splint for the second half), after which time the K-wires were removed. Patients were followed for a minimum of 4 months. Mean patient age was 9.5 years. Near-anatomical reduction was achieved easily with the intrafocal leverage technique in all fractures. Mean procedure time for K-wiring was 7 minutes. On follow-up, there was no loss of reduction; remanipulation was not performed in any case. There were no pin-related complications. All fractures healed, and full function of the wrist and forearm was achieved in every case. The Kapandji K-wire technique consistently achieves easy and near-anatomical closed reduction by a leverage reduction method in completely displaced pediatric distal radial fractures. Reduction is maintained throughout the fracture-healing period. The casting duration can be reduced without loss of reduction, and good functional results can be obtained.
authors.forename: Bhava R J
authors.initials: BR
authors.lastname: Satish
authors.forename: Muniramaiah
authors.initials: M
authors.lastname: Vinodkumar
authors.forename: Masilamani
authors.initials: M
authors.lastname: Suresh
authors.forename: Prasad Y
authors.initials: PY
authors.lastname: Seetharam
authors.forename: Krishnaraj
authors.initials: K
authors.lastname: Jaikumar
mesh_terms: D000293:Adolescent; D001864:Bone Wires; D002648:Child; D005260:Female; D005592:Fracture Fixation / Q000379:methods*; D006801:Humans; D008297:Male; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*