ULNAR SHAFT FRACTURE FIXATION BY ANTEGRADE VERSUS RETROGRADE INTRAMEDULLARY K WIRES IN CHILDREN: A COMPARATIVE STUDY | ||
| Egyptian Journal of Orthopedic Research | ||
| Volume 5, Issue 2, September 2025, Pages 111-118 PDF (470.6 K) | ||
| Document Type: Original articles: include clinical trials, interventional research, Basic researches and clinically relevant laboratory investigations | ||
| DOI: 10.21608/ejor.2025.455189 | ||
| Authors | ||
| Yasser Othman Sorour; Mahmoud Redwan; El Shazly S. Mosa; Moustafa Elsayed | ||
| Orthopedic Surgery dept., Sohag Faculty of Medicine, Sohag, Egypt | ||
| Abstract | ||
| Background: Diaphyseal ulnar fractures in children can be managed with either antegrade or retrograde intramedullary K-wire fixation, but their relative effects on recovery, healing time, and complications are still uncertain. Aim: To compare functional and radiological outcomes of antegrade versus retrograde intramedullary K-wire fixation in pediatric diaphyseal ulnar fractures. Methods: This prospective study of 60 children with diaphyseal ulnar fractures compared antegrade (n=24) and retrograde (n=36) intra-medullary K-wire fixation. Preoperative clinical and radiological evaluations were performed, and outcomes— including union time, hardware removal, joint function, pain, and complications—were assessed until fracture union. Data were analyzed using appropriate parametric and non-parametric tests, with significance set at p<0.05. Results: Baseline demographics and fracture characteristics were comparable between groups. The antegrade group demonstrated significantly faster union (6.08 ± 1.79 vs. 7.17 ± 1.16 weeks, p=0.006) and earlier hardware removal (4.83 ± 0.96 vs. 7.44 ± 1.38 weeks, p<0.001). Functional outcomes favored antegrade fixation, with superior supination, pronation, wrist motion, and ulnar deviation/extension (all p<0.01), and no wrist pain reported. Elbow stiffness was significantly less frequent in the antegrade group (p<0.001). No cases of hardware migration, refracture, or pin tract infection occurred in either group. Conclusion: Antegrade intramedullary K-wire fixation offers superior functional outcomes, faster healing, earlier hardware removal, and lower pain and stiffness rates compared to retrograde fixation, without increasing complications. It is particularly recommended for mid-shaft and proximal ulnar fractures in pediatric patients. | ||
| Keywords | ||
| Pediatric ulnar fracture; Antegrade fixation; Retrograde fixation; Intramedullary K-wire; Functional outcome | ||
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