A modified Kirschner wire fixation technique in the treatment of supracondylar humerus fractures in children under 8 years of age

Supracondylar humerus fractures (SCHF) are the most common elbow fractures in children. Closed reduction and percutaneous pinning (CRPP) is the standard surgical treatment, but complications such as Kirschner wires (K-wires) migration and fixation failure remain challenging. A modified K-wire fixation technique has been developed to address these issues. To evaluate the clinical efficacy of a novel K-wire fixation method for SCHF in children under 8 years old. A total of 120 children with SCHFs admitted to the Affiliated Hospital of Chengde Medical University between January 2016 and June 2024 were enrolled in this retrospective comparative study. Participants were divided into two groups according to the surgical technique they actually received.All eligible patients during the study period were consecutively included. No random sampling was performed. The study group ( n = 60) underwent a procedure involving the insertion of two K-wires from the lateral humeral condyle to the contralateral cortex, with the wire ends rotated and tightened. The control group ( n = 60) received standard treatment with two-wires inserted from the lateral humeral condyle to the contralateral cortex without the additional rotational step. Parameters such as operative time, time to fracture union, postoperative assessment based on Flynn’s criteria for elbow function, and occurrence of complications were documented and compared between the two groups. The study group had no cases of K-wire migration within the bone, contrasting with 6.7% in the control group; however, this difference did not reach statistical significance after Fisher’s exact test ( p = 0.119). Moreover, the overall complication rate was 0% in the study group and 8.33% in the control group ( p = 0.057, Fisher’s exact test). This method uses two lateral divergent K-wires with secured external ends, combined with stable cast immobilization. It offers a feasible and effective treatment strategy. This approach fulfills the biomechanical demands for supracondylar humerus fractures in children under 8 years old and, while mitigating iatrogenic injury, partially overcomes the limitations associated with smooth K-wires. These findings underscore the clinical utility and potential for broader application. Level III.