Electronic Letters to:

Children's Orthopaedics: C. W. B. Steinlechner and N. C. Mkandawire Non-vascularised fibular transfer in the management of defects of long bones after sequestrectomy in children J Bone Joint Surg Br 2005; 87-B: 1259-1263 [Abstract] [Full text] [PDF]

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Alternative technique of Kirschner wire fixation

Anil Agarwal   (30 September 2005)

Alternative technique of Kirschner wire fixation 30 September 2005
Anil Agarwal, Senior Reseach Associate Guru Teg Bahadur Hospital, Delhi, India Send letter to journal: Re: Alternative technique of Kirschner wire fixation rachna_anila{at}yahoo.co.in Anil Agarwal	Sir, We read the article by Steinlechner and Mkandawire with interest. One can understand the limitations of medical facilities in a country such as Malawi and appreciate the efforts of the surgeons to provide a functional limb. We would like to suggest an alteration to their technique of Kirschner wire fixation of fibular grafts. Instead of the wire being passed from the heel, it may be inserted from the metaphyseal region proximally to end in distal tibial region. In a more mature child, two wires can be inserted from either side to increase the stability. When the patient walks, even in plaster casts, as the heel is now free it is more comfortable to bear weight. The procedure also prevents violation of the ankle joint. We would also like to draw attention to the fact that the case numbers in the text and Table I are not the same. Case 6 involved the radius as per the table, whereas the text and Figure 6 depict lower limb function. The text describes case 4 taking 75 weeks for union, whereas it is case 3 in Table I. A. AGARWAL Guru Teg Bahadur, Delhi, India.