Diaphyseal forearm fractures in children treated with intramedullary fixation: outcome of K-wire versus elastic stable intramedullary nail.

Intramedullary fixation of children's diaphyseal forearm fractures is becoming the surgical technique of choice, in those cases that warrant surgical intervention. This method offers both technical advantages and patient benefits over alternative techniques and implants that have been used in the past. We present a two-centre study assessing the outcome of either Kirschner wires or elastic stable intramedullary nails (ESIN) as the method of fracture stabilisation in such diaphyseal forearm fractures.A total of 36 children underwent K-wire fixation and 24 children underwent ESIN fixation. All fractures united with no resultant subjective disability. The complication rate following K-wires was 16% and that following nail fixation 9%. Loss of forearm rotation was documented in four children in the K-wire group and three children stabilised with nails. These results confirm an excellent outcome following intramedullary fixation. We have demonstrated no difference in outcome between K-wires and ESIN, although the nails do offer some theoretical advantages.