Using a curved Kirschner wire for fixation of unstable distal radius fractures in children

Displaced metaphyseal and diaphyseal fractures of the distal radius are common in children. Using a plate-screw construct necessitates open reduction and a second operation to remove the metal work. Using a percutaneous Kirschner (K) wire can be attempted closed with an added advantage of a relatively minor procedure to remove the wire after fracture healing. However, using a straight wire may often be challenging due to the shallow angle the K wire needs to pass in order to engage the proximal fragment. Skin pressure and necrosis may also result at the insertion point. Rigidity of the K wire may result in ulnar deviation of the distal fragment and engaging the proximal fragment with a straight wire often necessitates starting the entry point at the tip of the radial styloid and thereby having to transgress the radial epiphysis (Figure 1).