DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20191556

Study of percutaneous K wire fixation in supracondylar fracture of humerus in children

Putappa Gopinath, Sabneet Singh, Abdul Ravoof

Abstract


Background: Closed reduction is difficult not only to achieve but also to maintain because of the thinness of bone of the distal humerus between the coronoid and olecranon where most supracondylar fractures occurs. For this reason percutaneous pinning techniques have become the treatment of choice for most supracondylar fractures. By this procedure even the displaced and rotated fracture can be treated successfully with minimal incidence of complications. The purpose of this study is to determine the efficacy of management of displaced supracondylar fractures using closed reduction with percutaneous K-wire pinning and to analyze the results, loss of carrying angle, and loss of motion with incidence of complications.

Methods: 20 cases of displaced supracondylar fractures in children aged between 5 and 12 years were treated by closed reduction and percutaneous pinning and were studied prospectively for functional outcome. 8 cases were treated with crossed pinning. 11 cases were treated with 3K wire fixation and 1 with lateral pinning.

Results: 85% of the patients observed excellent results. 15% of the patients observed fair results. Of the cases treated by 3K wire fixation 55% had excellent results and cases with crossed pinning 40% had good results and 5% had poor results. All the patients treated with lateral pinning had excellent results.

Conclusions: The results obtained in this study shows that anatomical reduction by closed method and stabilization with K-wire fixation is the first treatment of choice for displaced supracondylar fractures.


Keywords


Children, Humerus, K-wire, Supracondylar fracture

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References


John AH. Tachdjian's pediatric orthopaedics. 4th ed. Philadelphia: Saunders; 2008: 2451-2476.

Pirone AM. Management of displaced extension-type supracondylar fractures of the humerus in children. J Bone Joint Surg. 1988;70;641-50.

Skaggs DL, Cluck MW, Mostofi A, Flynn JM, Kay RM.Lateral-entry pin fixation in the management of Supracondylar fractures of humerus in children. J Bone Joint Surg Am. 2004;86:702–7.

Skaggs DL, Hale JM, Bassett J, Kaminsky C, Kay RM, Tolo VT. Operative treatment of Supracondylar fractures of humerus in children. The consequences of pin placement. J Bone Joint Surg Am. 2001;83:735–40.

Gordon JE, Patton CM, Luhmann SJ, Bassett GS, Schoenecker PL. Fracture stability after pinning of displaced Supracondylar fractures of humerus in children. J Pediatr Orthop. 2001;21:313–8.

Karapinar L, Ozturk H, Altay T, Kose B. Closed reduction and percutaneous pinning with three Kirschner wires in children with type III displaced Supracondylar fractures of the humerus. Acta Orthop Traumatol Turc. 2005;39:23–9.

Reynolds RA, Jackson H. Concept of treatment in Supracondylar humeral fractures. Injury. 2005;36(1):51–6.

Ippolito E, Caterini R, Scola E. Supracondylar fractures of the humerus in children. Analysis at maturity of fifty-three patients treated conservatively. J Bone Joint Surg Am. 1986;68:333–44.

Devnani AS. Late presentation of Supracondylar fracture of the humerus in Children. Clin Orthop Relat Res. 2005: 36–41.

Royce RO, Dutkowsky JP, Kasser JR, Rand FR. Neurologic complications after K-wire fixation of Supracondylar humerus fractures in children. J Pediatr Orthop. 1991;11:191–4.

Green DW, Widmann RF, Frank JS, Gardner MJ. Low incidence of ulnar nerve injury with crossed pin placement for paediatric Supracondylar humerus fractures using a mini-open technique. J Orthop Trauma. 2005;19:158–63.

Rasool MN. Ulnar nerve injury after K-wire fixation of Supracondylar humerus fractures in children. J Pediatr Orthop. 1998;18:686–90.

Devkumaran KC. Displaced Supracondylar fractures of humerus in children, primary open reduction and fixation with K-wires. IJO. 1985;19:120-5.

Rao SY, Chakravorthy M, Yadagiri. Percutaneous K Wire Fixation in SCFH. J Med Allied Sci. 2015;5(1):6-9.