BURIED VERSUS UNBURIED K-WIRE FIXATION: A COMPARATIVE STUDY OF PIN TRACT INFECTIONS IN PEDIATRIC GARTLAND TYPE III SUPRACONDYLAR HUMERUS FRACTURES

Objective: To assess the prevalence of pin tract infection in children with Gartland type III supracondylar humerus fractures who had buried or unburied Kirschner wire (K-wire) fixation. Study design: A Randomized controlled study. Place and Duration: This study was done at, Liaquat Institute of Medical and Health Science Thatta Hospital for period of 2 years from  Fabruary 2023 date to Fabruary 2025. Methods: In a tertiary care facility, this trial was carried out. Group A (buried K-wires) and Group B (unburied K-wires) were allocated to two equal groups of 80 pediatric patients with closed, radiologically confirmed Gartland type III fractures. All underwent lateral-entry K-wire fixation and were followed for 4 weeks postoperatively for assessment of PTI using the Modified Oppenheim Classification. Statistical analysis was conducted using the Chi-square test, with a significance level of p < 0.05 maintained. Results: Out of 80 patients, 16 (20%) developed pin tract infections. Group A (buried wires) showed a significantly lower PTI rate (12.5%, n=5) compared to Group B (27.5%, n=11). Most infections (68.7%) occurred in the unburied group. Infection was more prevalent in patients with delayed intervention beyond two weeks (38.9%) versus those treated within 1–2 weeks (17.7%). Underweight children predominantly received buried wires (93.3%), while overweight/obese children were more often treated with unburied wires. Gender differences were also noted; males were more likely to receive unburied K-wires (67.5%). Conclusion: Buried K-wire fixation significantly reduces the incidence of pin tract infections. Timely surgical intervention and BMI considerations also play a role in infection outcomes.