Clinical efficacy of two different K-wire fixation modes in proximal phalangeal base fractures in children

Wang Shuaiyin; Huang Zilong; Li Jiahui; Liu Shizhe; Fu Guibing

doi:10.3969/j.issn.1009-4237.2025.05.005

Abstract：Objective To compare the clinical efficacy of two K-wire fixation modes in treating proximal phalangeal base fractures in children.Methods A retrospective analysis was conducted on the data of 52 patients with base fractures of the proximal phalanx in children who were treated in the Department of Orthopedics of Shenz-hen Children's Hospital from Jan.2019 to Dec.2020.There were 34 males and 18 females aged 4-13(mean 8.4)years,with 16 epiphyseal plate fractures and 36 juxta-epiphyseal fractures.All the fractures were caused by falls and confirmed by preoperative X-rays.All of them received K-wire fixation,closed reduction and plaster external fixa-tion.Based on the fixation methods,patients were divided into Group A(n=22,longitudinal fixation with a single K-wire)and Group B(n=30,cross fixation with two K-wires).The baseline data between the two groups showed no significant differences.X-rays were taken at postoperative 2,4,and 6 weeks at the outpatient to observe the fracture healing,after which the K-wires were removed at the outpatient and functional exercises were recommended and guided.The two groups were compared in terms of pre-and post-operative fracture angulation angle,operation time,hospitalization days and cost,and postoperative functional recovery.Results The children were followed up for 3-12 months,with an average of 3.7 months,and all of them had excellent function.The operation time and hospitali-zation cost of Group A were statistically less than those in Group B(min,19.6±5.5 vs.24.0±8.0;yuan,5490.4±396.4 vs.5905.4±366.4,both P＜0.05).The pre-and post-operative fracture angulation angle,hospitalization days and functional recovery of the two groups showed no statistically significant differences(all P＞0.05).No post-operative complications of K-wire breakage,pin tract infection,bone bridge formation,rotational deformity or obvious angulation deformity were reported.Conclusion Compared with cross-fixation with two K-wires,longitudinal fixa-tion with a single K-wire can achieve the same satisfactory results in terms of postoperative appearance,function,and hospitalization time,but the operation time and hospitalization cost were much less.