{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:28:26Z","timestamp":1790688506649,"version":"4.1.0"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study evaluated the therapeutic efficacy of a novel percutaneous Kirschner wire (K-wire) fixation combined with the K-Hammer technique in pediatric patients with supracondylar humeral fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 34 pediatric patients [13 males (38.24%); 21 females (61.76%); mean age 5.82\u2009\u00b1\u20092.54 years] with acute extension-type supracondylar humeral fractures (diagnosed \u22647 days post-trauma). Under general anesthesia, fractures underwent fluoroscopy-guided closed reduction and percutaneous fixation: two lateral-entry 1.5\u20132.0\u2005mm K-wire provided initial stabilization, followed by a third medial-entry K-wire inserted using the K-Hammer technique to achieve a biomechanically optimized cross-pinning configuration. Postoperatively, the elbow was immobilized in a 90\u00b0 functional position with a long-arm fiberglass cast for 4 weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over a mean follow-up of 12.24\u2009\u00b1\u20094.45 months (range: 6\u201323 months), functional outcomes per Flynn's criteria were excellent in 32 patients (94.12%), good in 2 (5.88%), and fair in 0 (0%). No cases of secondary displacement, osteonecrosis, or major complications\u2014such as nonunion, iatrogenic neurovascular injury, myositis ossificans, or chronic elbow dysfunction\u2014were observed during postoperative monitoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The K-Hammer-assisted medial K-wire insertion provides a streamlined, reproducible approach for managing irreducible extension-type pediatric supracondylar humeral fractures. It effectively mitigates iatrogenic ulnar nerve injury, minimizes soft tissue trauma, ensures biomechanical stability, and promotes optimal long-term elbow kinematics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2025.1718195","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T06:44:12Z","timestamp":1765953852000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["K-Hammer percutaneous fixation: a novel technique for preventing iatrogenic ulnar nerve injury in pediatric supracondylar humeral fractures"],"prefix":"10.3389","volume":"13","author":[{"given":"Yijun","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoan","family":"Bai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changhong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mi","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Bai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanwen","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1302\/2058-5241.3.170049","article-title":"Management 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