{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T15:36:10Z","timestamp":1776699370346,"version":"3.51.2"},"reference-count":21,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,3,18]],"date-time":"2023-03-18T00:00:00Z","timestamp":1679097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Closed reduction and K-wire fixation of displaced distal radius fractures in children and adolescents is an established and successful surgical procedure. Fracture-related infections after K-wire fixation are rare but can have significant consequences for the patient. There is a lack of literature on the treatment of K-wire-associated fracture-related infections in children and adolescents. Herein, we report two cases of fracture-related infection after initial closed reduction and Kirschner wire fixation in two adolescents. One 13-year-old boy and one 11-year-old girl were seen for fracture-related infections 4 and 8 weeks after closed reduction and percutaneous K-wire fixation of a distal radius, respectively. X-ray and magnetic resonance imaging (MRI) revealed a healed fracture with osteolytic changes in the metaphyseal radius with periosteal reaction and abscess formation of the surrounding soft tissue structures. A two-staged procedure was performed with adequate debridement of the bone and dead space management with an antibiotic-loaded polymethyl methacrylate (PMMA) spacer at stage 1. After infection control, the spacer was removed and the defect was filled with autologous bone in one case and with a calcium sulphate\u2013hydroxyapatite biomaterial in the other case. In each of the two patients, the infection was controlled and a stable consolidation of the distal radius in good alignment was achieved. In one case, the epiphyseal plate was impaired by the infection and premature closure of the epiphyseal plate was noted resulting in a post-infection ulna plus variant. In conclusion, a fracture-related infection after Kirschner wire fixation of pediatric distal radius fractures is a rare complication but can occur. A two-stage procedure with infection control and subsequent bone defect reconstruction was successful in the presented two cases. Premature closure of the epiphyseal growth plate of the distal radius is a potential complication.<\/jats:p>","DOI":"10.3390\/children10030581","type":"journal-article","created":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T04:33:31Z","timestamp":1679286811000},"page":"581","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Treatment of Fracture-Related Infections with Bone Abscess Formation after K-Wire Fixation of Pediatric Distal Radius Fractures in Adolescents\u2014A Report of Two Clinical Cases"],"prefix":"10.3390","volume":"10","author":[{"given":"Markus","family":"Scharf","sequence":"first","affiliation":[{"name":"Department for Trauma Surgery, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0654-2076","authenticated-orcid":false,"given":"Nike","family":"Walter","sequence":"additional","affiliation":[{"name":"Department for Trauma Surgery, University Hospital Regensburg, 93053 Regensburg, Germany"},{"name":"Department for Psychosomatic Medicine, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7221-3783","authenticated-orcid":false,"given":"Markus","family":"Rupp","sequence":"additional","affiliation":[{"name":"Department for Trauma Surgery, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0208-4650","authenticated-orcid":false,"given":"Volker","family":"Alt","sequence":"additional","affiliation":[{"name":"Department for Trauma Surgery, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1080\/17453674.2016.1258532","article-title":"The AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF)","volume":"88","author":"Joeris","year":"2017","journal-title":"Acta Orthop."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1302\/2633-1462.36.BJO-2022-0040.R1","article-title":"Children\u2019s distal forearm fractures: A population-based epidemiology study of 4316 fractures","volume":"3","author":"Korup","year":"2022","journal-title":"Bone Jt. 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Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"S59","DOI":"10.1016\/j.injury.2006.04.010","article-title":"Diagnosis and treatment of infections associated with fracture-fixation devices","volume":"37","author":"Trampuz","year":"2006","journal-title":"Injury"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Rupp, M., Walter, N., Popp, D., Hitzenbichler, F., Heyd, R., Geis, S., Kandulski, M., Thurn, S., Betz, T., and Brochhausen, C. (2023). Multidisciplinary Treatment of Fracture-Related Infection Has a Positive Impact on Clinical Outcome\u2014A Retrospective Case Control Study at a Tertiary Referral Center. Antibiotics, 12.","DOI":"10.3390\/antibiotics12020230"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1007\/s00402-019-03287-4","article-title":"General treatment principles for fracture-related infection: Recommendations from an international expert group","volume":"140","author":"Metsemakers","year":"2020","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1097\/BPO.0000000000000208","article-title":"Kirschner wire infections in pediatric orthopaedic surgery","volume":"35","author":"Tosti","year":"2015","journal-title":"J. Pediatr. Orthop."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1097\/bpo.0b013e3180317a22","article-title":"Incidence of pin track infections in children\u2019s fractures treated with Kirschner wire fixation","volume":"27","author":"Battle","year":"2007","journal-title":"J. Pediatr. Orthop."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1097\/00005373-200102000-00017","article-title":"Treatment of diaphyseal forearm fractures in children by intramedullary Kirschner wires","volume":"50","author":"Qidwai","year":"2001","journal-title":"J. Trauma"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1097\/01241398-200401000-00002","article-title":"Percutaneous transphyseal intramedullary Kirschner wire pinning: A safe and effective procedure for treatment of displaced diaphyseal forearm fracture in children","volume":"24","author":"Yung","year":"2004","journal-title":"J. Pediatr. Orthop."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1302\/0301-620X.80B1.0800091","article-title":"Percutaneous intramedullary Kirschner wiring for displaced diaphyseal forearm fractures in children","volume":"80","author":"Yung","year":"1998","journal-title":"J. Bone Jt. Surg. Br."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/j.cmi.2019.08.006","article-title":"Pathogenesis and management of fracture-related infection","volume":"26","author":"Depypere","year":"2020","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Szymski, D., Walter, N., Alt, V., and Rupp, M. (2022). Evaluation of Comorbidities as Risk Factors for Fracture-Related Infection and Periprosthetic Joint Infection in Germany. J. Clin. Med., 11.","DOI":"10.3390\/jcm11175042"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.injury.2016.09.019","article-title":"Infection after fracture fixation: Current surgical and microbiological concepts","volume":"49","author":"Metsemakers","year":"2018","journal-title":"Injury"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/j.injury.2017.08.040","article-title":"Fracture-related infection: A consensus on definition from an international expert group","volume":"49","author":"Metsemakers","year":"2018","journal-title":"Injury"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"76","DOI":"10.7150\/jbji.31592","article-title":"Radiographic and Histological Analysis of a Synthetic Bone Graft Substitute Eluting Gentamicin in the Treatment of Chronic Osteomyelitis","volume":"4","author":"Ferguson","year":"2019","journal-title":"J. Bone Jt. Infect."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"934485","DOI":"10.3389\/fcimb.2022.934485","article-title":"The Microbiological Etiology of Fracture-Related Infection","volume":"12","author":"Depypere","year":"2022","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1097\/BOT.0000000000001626","article-title":"Recommendations for Systemic Antimicrobial Therapy in Fracture-Related Infection: A Consensus from an International Expert Group","volume":"34","author":"Depypere","year":"2020","journal-title":"J. Orthop. Trauma"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Baertl, S., Walter, N., Engelstaedter, U., Ehrenschwender, M., Hitzenbichler, F., Alt, V., and Rupp, M. (2022). What Is the Most Effective Empirical Antibiotic Treatment for Early, Delayed, and Late Fracture-Related Infections?. Antibiotics, 11.","DOI":"10.3390\/antibiotics11030287"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/3\/581\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:58:11Z","timestamp":1760122691000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/3\/581"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,18]]},"references-count":21,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["children10030581"],"URL":"https:\/\/doi.org\/10.3390\/children10030581","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,18]]}}}