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Displaced distal end radius fractures in children treated with Kirschner wires - A systematic review.

The indications for Kirschner wiring, the technique of wiring, type of cast immobilization, period of immobilization and complications of K wires are unclear. We conducted a systematic review of the literature on Kirschner wiring of distal radius fractures in children. A total of 4263 articles were identified. The full text of the remaining 78 articles was reviewed. 64 articles were finally excluded because of incomplete data leaving 14 for analysis. Complete fracture displacement and translation more than 50% are the commonest indications for Kirschner wiring of these fractures with 2 retrograde wires in non-Kapandji fashion being the commonest technique. Long arm casts are the favored modality of immobilization with superficial infection being the commonest complication. Re-displacement rates are low after Kirschner wiring. Most studies were retrospective and there is the need for a multicenter randomized controlled trial to define protocols for management of displaced distal radius fractures in children.