Acupressure in Pediatric K-wire Removal

This study is designed to evaluate pain associated with K-wire (Kirschner wire) removal in children and to compare pain outcomes between an intervention group and a control group. Children who meet the study eligibility criteria and are scheduled for K-wire removal will be included.

Participants will be assigned to an intervention group or a control group according to the study protocol. Pain intensity will be assessed using the Visual Analog Scale (VAS), ranging from 0 (no pain) to 10 (worst possible pain). Pain will be assessed immediately before and after K-wire removal.

Pain assessments will be obtained independently from three perspectives: the child, the parent, and the researcher. The agreement among these three assessments will also be evaluated.

The primary purpose of the study is to determine whether the intervention is associated with a greater reduction in pain compared with the control condition. Pain scores before and after the procedure will be compared within and between the study groups.

The findings of this study may contribute to a better understanding of pain management during K-wire removal in children and may help inform clinical approaches for reducing procedural pain.

Inclusion criteria

• Children aged 6-12 years. First-time K-wire removal following treatment for an elbow fracture. Able to communicate verbally and understand and speak Turkish. No chronic pain, psychiatric, developmental, or sensory disorders. No physical condition preventing acupressure application at the LI4 point. No opioid, narcotic analgesic, or sedative medication use within 8 hours before the procedure.

Written informed consent obtained from both the child and parent after being informed about the study.

Exclusion criteria

• Neurological or psychiatric disorders that may affect pain perception. Developmental or sensory disabilities. Inability to communicate or cooperate during the procedure. Use of opioid, narcotic analgesic, or sedative medication within 8 hours before the procedure.

Requirement for analgesic or sedative medication during the procedure. K-wire removal not completed in a single session. Complications during the procedure, such as prolonged or traumatic K-wire removal.

Wound, infection, dressing, fracture, inflammation, or other local contraindications at the LI4 acupressure site.

Withdrawal of informed consent by the child or parent during the study