Buried vs. Unburied K-Wire Fixation: Impact on Pin Tract Infection in Pediatric Gartland Type III Supracondylar Humerus Fractures

Background: Pin tract infections are a common complication of Kirschner wire (K-wire) fixation in the management of Gartland Type III supracondylar humerus fractures in children. Whether buried or unburied K-wires result in lower infection rates remains a subject of debate. Objective: To compare the infection rates of buried versus unburied K-wire fixation in pediatric patients with Gartland Type III supracondylar humerus fractures. Material and Methods: This randomized controlled trial was conducted in the Nishtar Medical University Multan, from September 2023 to August, 2024. A total of 200 patients aged 4–12 years were equally divided into two groups: Group A (Buried K-Wires) and Group B (Unburied K-Wires). Patients were followed for signs of pin tract infection, and data were analyzed using Pearson’s Chi-Square test. Results: The mean age was 8.04 ± 2.58 years, and the mean duration of fixation was 4.93 ± 0.79 weeks. Pin tract infections were significantly lower in Group A, with 11 (11.0%) cases, compared to 27 (27.0%) in Group B (p = 0.004). Infection rates were notably higher in the unburied group among males (p = 0.016) and when the duration of fixation exceeded four weeks (p = 0.004). Although differences in infection rates across age groups were not statistically significant, a consistent trend of higher infections in the unburied group was observed. Conclusion: Buried K-wire fixation is safer and more effective in reducing pin tract infections, particularly in males and with extended fixation durations, supporting its use as the preferred technique