Buried vs. Unburied K-Wire Fixation: Impact on Pin Tract Infection in Pediatric Gartland Type III Supracondylar Humerus Fractures

Authors

  • Nasir Hussain
  • Muhammad Kamran Shafi
  • Tauseef Raza
  • Aman Ullah Khan Kakar
  • Sijad Ahmed Mahar
  • Yousaf Gul
  • Abdullah Abdullah

DOI:

https://doi.org/10.63682/jns.v13i1.6963

Abstract

Background: Pin tract infections are a common complication of Kirschner wire (K-wire) fixation in the management of Gartland Type III supracondylar humerus fractures in children. Whether buried or unburied K-wires result in lower infection rates remains a subject of debate.

Objective: To compare the infection rates of buried versus unburied K-wire fixation in pediatric patients with Gartland Type III supracondylar humerus fractures.

Material and Methods: This randomized controlled trial was conducted in the Nishtar Medical University Multan, from September 2023 to August, 2024. A total of 200 patients aged 4–12 years were equally divided into two groups: Group A (Buried K-Wires) and Group B (Unburied K-Wires). Patients were followed for signs of pin tract infection, and data were analyzed using Pearson’s Chi-Square test.

Results: The mean age was 8.04 ± 2.58 years, and the mean duration of fixation was 4.93 ± 0.79 weeks. Pin tract infections were significantly lower in Group A, with 11 (11.0%) cases, compared to 27 (27.0%) in Group B (p = 0.004). Infection rates were notably higher in the unburied group among males (p = 0.016) and when the duration of fixation exceeded four weeks (p = 0.004). Although differences in infection rates across age groups were not statistically significant, a consistent trend of higher infections in the unburied group was observed.


Conclusion: Buried K-wire fixation is safer and more effective in reducing pin tract infections, particularly in males and with extended fixation durations, supporting its use as the preferred technique

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References

Wormald J, Jain A, Lloyd-Hughes H, et al. A systematic review of the influence of burying or not burying Kirschner wires on infection rates following fixation of upper extremity fractures. J PlastReconstrAesthet Surg. 2017;70(9):1298-1301. DOI:10.1016/j.bjps.2017.06.036

Saeed U, Waseem M, Hassan AR, et al. Comparison of buried vs non-buried K-wires for treatment of supracondylar fracture. Prof Med J. 2020;27(3):467-471. DOI:10.29309/tpmj/2020.27.03.3052

Sahoo M, Sahoo US, Jena M. Exposed versus buried K-wire fixation in paediatric lateral condyle humerus fractures. J PediatrOrthop B. 2021;31:281-288. DOI:10.1097/BPB.0000000000000880

Suganuma S, Tada K, Takagawa S, et al. Comparing exposed and buried Kirschner wires in fixation for pediatric supracondylar humerus fractures. J Orthop Surg. 2022;30. DOI:10.1177/10225536221125949

Lu D, Wang T, Chen H, et al. Management of pin tract infection in pediatric supracondylar humerus fractures. Eur J Pediatr. 2017;176(5):615-620. DOI:10.1007/s00431-017-2884-1

Gupta SK, Esposito ER, Phillips R, et al. Effect of antibiotic prophylaxis on infection rates in pediatric supracondylar humerus fractures. J Am AcadOrthop Surg. 2024;32:410-416. DOI:10.5435/JAAOS-D-23-00795

Abdullah S, Soh EZ, Ngiam CJ, et al. A prospective study comparing the infection rate between buried vs exposed Kirschner wires. Cureus. 2023;15(3). DOI:10.7759/cureus.36558

Hidajat NN, Satrio RM, Magetsari N, et al. Buried or exposed Kirschner wire for the management of hand and forearm fractures. Meta-analysis. 2023. DOI:10.1101/2023.12.07.23299683

Hannonen J, Pokka T, Serlo W, et al. Lateral-only Kirschner-wire fixation of Type-3 supracondylar humerus fractures. Scand J Surg. 2020;110:258-264. DOI:10.1177/1457496920908770

Bhatt EM, Ridley TJ, Kruckeberg BM, et al. Efficacy of antibiotics in supracondylar fractures. J PediatrOrthop. 2021;41:e750-e754. DOI:10.1097/BPO.0000000000001901

Marson B, Ikram A, Craxford S, et al. Interventions for treating supracondylar elbow fractures in children. Cochrane Database Syst Rev. 2022;6:CD013609. DOI:10.1002/14651858.CD013609.pub2

Schneidmueller D, Kertai M, Bühren V, et al. Kirschner wire osteosynthesis for fractures in childhood: bury wires or not? Unfallchirurg. 2018;121(10):817-824. DOI:10.1007/s00113-018-0465-z

Inam M, Ullaha T, Rahman W. Comparison of Pin Tract Infection Rate in Buried Versus Unburied Kirschner Wires Fixation in the Management of Gartland Type III Supracondylar Fracture of Humerus in Children. Journal of Pakistan Orthopaedic Association. 2024;36(1):41-7.

Kafle G, Pokhrel A, Gupta MK, et al. Comparison of outcomes in buried versus exposed Kirschner wire for treatment of paediatric supracondylar humerus fractures. Birat Journal of Health Sciences. 2023;8(3):2126-32.

Saeed UB, Waseem M, Hassan AR, et al. Supracondylar fracture, buried vs non buried K wires. The Professional Medical Journal. 2020;27(3):467-71.

Aubret S, Lecointe T, Mansour M, et al. Risk of infection and secondary displacement in pediatric supracondylar or lateral condyle fractures treated with unburied Kirchener-wires. Journal of Pediatric Orthopaedics B. 2017;26(3):222-6.

Saeed UB, Waseem M, Hassan AR, et al. Comparison of Buried vs Non Buried K Wires for Treatment of Supracondylar Fracture. Power. 2020;1(2.27):9.

Suganuma S, Tada K, Takagawa S, et al. Comparing exposed and buried Kirschner wires in fixation for pediatric supracondylar humerus fractures: a propensity score-matched study. Journal of Orthopaedic Surgery. 2022;30(3):10225536221125949.

Bhatti SH, Abbasi MK, Naqvi AS, et al. Percutaneous pinning vs open reduction K wire fixation in Gartland Type III supracondylar humerus fracture in children. Rawal Medical Journal. 2022;47(3):640.

Abdullah S, Soh EZ, Ngiam CJ, et al. A Prospective Study Comparing the Infection Rate Between Buried vs Exposed Kirschner Wires in Hand and Wrist Fixations. Cureus. 2023;15(3)

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Published

2025-07-22

How to Cite

1.
Hussain N, Shafi MK, Raza T, Khan Kakar AU, Mahar SA, Gul Y, Abdullah A. Buried vs. Unburied K-Wire Fixation: Impact on Pin Tract Infection in Pediatric Gartland Type III Supracondylar Humerus Fractures. J Neonatal Surg [Internet]. 2025Jul.22 [cited 2025Sep.19];13(1):525-9. Available from: https://www.jneonatalsurg.com/index.php/jns/article/view/6963

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