Background: Distal forearm fractures are common in children. Many studies have described high failure rate when treated by closed reduction and immobilization in plaster cast. Loss of reduced position in the cast has been shown to be the most important factor leading to malunion and failure of the treatment. Treating these fractures by closed reduction and percutaneous Kirsch-ner (K-) wiring has been recommended.

Objective: This study aims at determining the value of management of distal forearm fractures in children by closed reduction and percutaneous K-wiring in avoiding treatment failure and improving the final outcome.

Material and methods: A series of 70 displaced distal forearm fractures in children was studied. These children were randomly allocated to one of two treatment groups: either manipulation and cast alone, or manipulation and percutaneous K-wiring with cast. Both groups were followed up until union occurred. Looking at the incidence of redisplacement, the radiological position at union, and the functional results four months after injury.

Results: Redisplacement occurred in 8 out of 35 patients in the cast group (23%), compared to none in the K-wiring group (the difference was statistically significant).The quality of reduction was significantly better in the K-wire group, both initially and at union. Only 59 patients (84%) were reviewed 4 months after injury, none of the children in both groups had functional deficit.