{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T11:47:09Z","timestamp":1785757629397,"version":"3.56.0"},"reference-count":27,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"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>Background: K-wire osteosynthesis is a widely used, cost-effective technique for stabilizing pediatric and adolescent fractures. The beneficial effect of perioperative antibiotic prophylaxis (PAP) and burying the K-wires below skin level to reduce infectious complications is still controversial. The goal of this study was to evaluate if the omission of PAP and leaving K-wires unburied affected the complication rate. Materials and Methods: A retrospective analysis of pediatric and adolescent K-wire osteosyntheses over a period of 11 years was performed. Records were screened for general, infectious and implant-associated complications. Follow-up was performed until the implant was removed. Results: Between January 2014 and December 2024 a total of 1022 K-wire osteosyntheses were performed and 779 were eligible for this study. Median follow-up to implant removal was 30 days [28\u201336 days]. At least one complication was documented in 17.6% (137\/779) of the cases. Infectious complications were low at 2.6%\u2014including 11 (1.4%) wound healing disorders and 9 (1.2%) pin site infections\u2014and did not show difference regardless of application of PAP. No cases of osteomyelitis were observed until follow-up. Furthermore, implant-associated complications were more frequent with buried wires (10.2%; 19\/187) than with unburied wires (3.4%, 20\/592). Conclusions: Omitting perioperative antibiotic prophylaxis and leaving K-wires unburied in pediatric and adolescent patients undergoing closed reduction and K-wire fixation of distal radial and distal humeral fractures does not seem to increase the risk for infectious complications. Furthermore, unburied K-wires can be removed without the need for a second general anesthesia. Level of Evidence: III (retrospective cohort study).<\/jats:p>","DOI":"10.3390\/children13081033","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T10:24:07Z","timestamp":1785752647000},"page":"1033","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Is Less More? The Need of Perioperative Antibiotic Prophylaxis and Burying K-Wires in Pediatric Trauma Surgery\u2014A Retrospective Analysis of 779 Distal Forearm and Distal Humeral Osteosyntheses"],"prefix":"10.3390","volume":"13","author":[{"given":"Nadja","family":"Schmidt","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery and Orthopedics, Clinic St. Hedwig, Barmherzige Brueder Regensburg, KUNO Pediatric University Medical Center, Steinmetzstra\u00dfe 1-3, 93049 Regensburg, Germany"},{"name":"Department of Trauma Surgery, University Medical Centre Regensburg, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4109-1901","authenticated-orcid":false,"given":"Clemens","family":"Memmel","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Orthopedics, Clinic St. Hedwig, Barmherzige Brueder Regensburg, KUNO Pediatric University Medical Center, Steinmetzstra\u00dfe 1-3, 93049 Regensburg, Germany"},{"name":"Department of Trauma Surgery, University Medical Centre Regensburg, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Wulbrand","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Orthopedics, Clinic St. Hedwig, Barmherzige Brueder Regensburg, KUNO Pediatric University Medical Center, Steinmetzstra\u00dfe 1-3, 93049 Regensburg, Germany"},{"name":"Department of Trauma Surgery, University Medical Centre Regensburg, 93053 Regensburg, Germany"},{"name":"Department for Trauma, Orthopedics and Sports Medicine, Hospital Barmherzige Brueder Regensburg, Pr\u00fcfeninger Stra\u00dfe 86, 93049 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Hanke","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Orthopedics, Clinic St. Hedwig, Barmherzige Brueder Regensburg, KUNO Pediatric University Medical Center, Steinmetzstra\u00dfe 1-3, 93049 Regensburg, Germany"},{"name":"Department of Trauma Surgery, University Medical Centre Regensburg, 93053 Regensburg, Germany"},{"name":"Department for Trauma, Orthopedics and Sports Medicine, Hospital Barmherzige Brueder Regensburg, Pr\u00fcfeninger Stra\u00dfe 86, 93049 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"89","DOI":"10.4103\/0970-0358.41122","article-title":"Historical remarks on Martin Kirschner and the development of the Kirschner (K)-wire","volume":"41","author":"Huber","year":"2008","journal-title":"Indian J. 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