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ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2026

Buried K-wires in paediatric fracture fixation: infection and complication rates in a large cohort.

Alexa Zimmermann, Johanna Thiele, Christian Prangenberg, Jonas Roos, Davide Cucchi, Sebastian Scheidt, Kristian Welle, Lisa Fiona Roder

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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8 authors.

Alexa ZimmermannDepartment of Orthopedics and Trauma Surgery, University of Bonn, University Hospital Bonn, Bonn, Germany.
Johanna ThieleDepartment of Orthopedics and Trauma Surgery, University of Bonn, University Hospital Bonn, Bonn, Germany.
Christian PrangenbergDepartment of Orthopedics and Trauma Surgery, University of Bonn, University Hospital Bonn, Bonn, Germany.
Jonas RoosDepartment of Orthopedics and Trauma Surgery, University of Bonn, University Hospital Bonn, Bonn, Germany. jonas.roos@ukbonn.de.
Davide CucchiDepartment of Orthopedics and Trauma Surgery, University of Bonn, University Hospital Bonn, Bonn, Germany.
Sebastian ScheidtDepartment of Orthopedics and Trauma Surgery, University of Bonn, University Hospital Bonn, Bonn, Germany.
Kristian WelleDepartment of Orthopedics and Trauma Surgery, University of Bonn, University Hospital Bonn, Bonn, Germany.
Lisa Fiona RoderDepartment of Orthopedics and Trauma Surgery, University of Bonn, University Hospital Bonn, Bonn, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeKirschner wires (K-wires) are widely used for fracture fixation in paediatric trauma surgery. Although infectious complications are uncommon, they remain clinically relevant. Subcutaneous burial of K-wires has been proposed to reduce the risk of infection, but robust data from large paediatric cohorts remain limited. This study aimed to evaluate infectious and non-infectious complications following routine use of buried K-wires in children.

methodsIn this retrospective cohort study, paediatric patients (≤ 18 years) who underwent fracture fixation with routinely buried K-wires at a Level I trauma centre between January 2005 and November 2025 were included. Only patients with complete follow-up, including radiographic assessment and wire removal at the study institution, were analysed. The primary outcome was postoperative infection related to K-wire fixation. Secondary outcomes included non-infectious wound complications, reoperations, and fracture healing.

resultsA total of 634 patients with a mean age of 10.2 ± 4.2 years were included; 96.8% sustained upper-extremity fractures. One superficial infection occurred (0.16%; 95% CI 0.00-0.88%), with no cases of deep infection or osteomyelitis. Secondary skin perforation without infection was observed in 8.36%, and minor wound-healing disturbances in 0.32%. No infection-related reoperations were required, and all fractures healed radiographically.

conclusionsRoutine subcutaneous burial of K-wires in paediatric fracture fixation was associated with an exceptionally low rate of infectious complications and no cases of osteomyelitis in this large retrospective cohort. However, secondary skin perforation occurred in 8.36% of patients, and planned wire removal under anaesthesia represents an additional procedural burden. Given the predominance of upper-extremity fractures and the absence of an exposed-wire control group, these findings should be interpreted within the studied population and do not establish superiority over exposed K-wires.

Indexed as

Bone WiresFracture Fixation, InternalFractures, BonePostoperative ComplicationsSurgical Wound InfectionAdolescentChildChild, PreschoolFemaleFracture HealingHardware RemovalHumansMaleReoperationRetrospective StudiesBuried K-wiresInfection rateKirschner wire infectionPaediatric fracture fixationPaediatric trauma surgeryPostoperative complications

Identifiers

PMID42836880
PMCPMC13642419

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