Kamarul Izham, Kamarudin
(2011)
Comparison on outcome for closed fracture radius and ulna in children
treated with cast and intramedullary K-wire.
Masters thesis, Pusat Pengajian Sains Perubatan.
Abstract
This is a retrospective study which was conducted to compare between intramedullary kwire
fixation and cast for the treatment of closed fracture midshaft of radius and ulna in
children.
Thirty one patients treated with cast and twenty patients treated with intramedullary kwire
were traced from Hospital Sultanah Bahiyyah, Alor Setar from 2004 to 2009
between the age of 8 to 14 years old. • Cases were evaluated in 2 groups, one treated with
cast and another group of patients treated with intramedullary k-wire. All patients were
evaluated for radiological outcome at 1 week and 6 week, clinical outcome in terms of
range of supination and pronation at 6 week follow-up by grading them using Daruwalla
Grading and surgical complication of intramedullary k-wiring at 6 week.
There was no significant difference between the two methods of treatment in their
effectiveness to prevent angulation at fracture site at week 1 follow-up (mean: IM k-wire
7.75°; cast 6.39<l) with p value more than 0.05. The difference at week 6 follow-up also
not significant (mean IM k-wire 7.85°; cast 7.03°) with p value more than 0.05. There
was also no significant correlation between the two methods of treatment and the clinical
outcome. Age was the most determinant factors on the clinical outcome based on
Daruwalla grading system. However, gender and side hand dominant have no effect on
clinical outcome. The treatment method have no effect on clinical outcome on Logistic
Regression test. As a conclusion, there was no significant different between intramedullary k-wiring and
cast in the management of closed fracture midshaft of radius and ulna in children in
terms of preventing fracture angulation and restoring range of supination and pronation.
This study also showed that age was the single most important factor to determine the
clinical outcome of the patients with this type of fracture.
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