Salter-Harris II distal radial fractures treated with the intrafocal K-wire technique: a retrospective study of 20 cases

We retrospectively reviewed 20 children with Salter-Harris II fractures of the distal radius treated with intrafocal pinning according to Kapandji. Unlike conventional crossed K-wire pinning, this method avoids crossing the physis with the pins and thus minimizes the risk of physeal damage. None of the children had fracture re-displacement, angulation or growth deformities. The age, sex, side of injury, fracture displacement or angulation, treatment delay or immobilization period had any significant impact on the functional outcome. At a mean follow-up of 49 months (range 47–60), plain radiographs and MRI showed no growth arrests or physeal bars or bridges. Grip strength, wrist motion and patient-reported outcomes were almost normal with no or minimal pain at the injury site. We conclude that intrafocal K-wire pinning is simple, safe and affordable. We cannot provide data on what is acceptable fracture displacement for different age groups to allow for acceptable final remodelling of any malalignment. Level of evidence: IV