Ulnar Nerve Injury After K-Wire Fixation of Supracondylar Humerus Fractures in Children

1998 ◽  
Vol 18 (5) ◽  
pp. 686-690 ◽  
Author(s):  
Mahomed Noor Rasool
2020 ◽  
Vol 27 (03) ◽  
pp. 476-480
Author(s):  
Farhan Majeed ◽  
Mudasser Saddique ◽  
Hafiz Nasir ◽  
Ahmad Shams

Around the elbow, supracondylar injury of humerus is one of the conventional fractures which usually occurs at the age of 7 to 8 years. Various conservative techniques have been used for the management, which comprises of the splintage, tractions, open or closed reduction with k wire fixation. However, closed reduction and percutaneous pinning remains the mainstay of surgical management, for they have shown splendid outcomes according to many authors. Objectives: The aim of this study is to summarise and compare the radiological and functional results of two ways of fixation (cross and parallel closed K wires) of supracondylar fractures in children. Study Design: Randomized controlled trial. Setting: Department of Orthopaedics Surgery, Services Hospital, Lahore. Period: 1st January 2018 to 31st June 2018. Material & Methods: We included 180 patients (90 in each group). Results: The mean age was 6.45±2.34 years with 115(63.9%) male and 65(36.1%) female. Among the children who underwent fixation with cross k-wires, ulnar nerve injury was seen in 2(2.2%) cases and none were seen in the other group post operatively. Group A attained higher union rate at last follow up. 4(4.4%) cases in Cross K-wires and 19(21.1%) in two lateral k-wires gave outstanding outcome. In a nutshell, 60 in group A and 45 in group B showed excellent outcomes based on Flynn's criteria, p-value < 0.05. Conclusion: According to Flynn’s criteria, closed percutaneous cross K-wire fixation of supracondylar fracture of humerus is an effective management option in terms of finer functional results as compared to Parallel k-wires. Although, the rate of radiological union is higher in cross k-wire fixation, there are 2.2% chances of ulnar nerve injury.


2019 ◽  
Vol 10 (2) ◽  
pp. 58-61
Author(s):  
Krishna Sapkota ◽  
Krishna Wahegaonkar ◽  
Niraj Ranjeet ◽  
Pabin Thapa ◽  
Upendra Jung Thapa ◽  
...  

Background: Supracondylar fracture of distal humerus is the most common paediatric fracture. Type III supracondylar fractures should be treated with anatomical reduction and stable Kirschner wire (K- wire, pin) fixation to prevent the cosmetic deformity. The configuration of wires is debatable. Although two crossed K-wires are bio-mechanically stable, there is a risk of iatrogenic ulnar nerve injury. Lateral 3 K-wires is a good alternative. This study was done to compare the outcome of cross K- wire and lateral 3 K-wires in terms of stability. Materials and Methods: This is a prospective study done in Manipal Teaching Hospital. All the Gartland type 3 supracondylar fractures of the distal humerus were treated with closed reduction and stabilized with K wires. In Group I, fractures were stabilized with cross K wire fixation and in group II they were stabilized with 3 lateral K-wires. The patients were followed up at 4-5 weeks for wire removal and at 3 months and 6 months after surgery. Baumann's angle, a functional outcome as per Flynn's criteria, and range of motion were recorded in each visit. Outcomes were compared in term of displacement of fracture. Result: Seventeen children in each group were taken up for the study. There were no significant differences in term of patients and fracture character. No patients had significant loss of reduction at final follow up. There is no statistically significant difference seen in mean changes of Bauman's angle. According to Flynn's criteria good result was seen in more than 95% of cases in both groups. Conclusion: Both cross K-wires and Lateral 3 K-wires provide good stability. Fixation of supracondylar fracture from lateral side had an advantage of no risk of iatrogenic Ulnar nerve injury. Addition of third K-wire from lateral side provides good stability as that of cross K- wire fixation.


1998 ◽  
Vol 18 (5) ◽  
pp. 683-685 ◽  
Author(s):  
Rafael Neiman ◽  
Brian Maiocco ◽  
Vincent F. Deeney

1998 ◽  
Vol 18 (5) ◽  
pp. 683-685 ◽  
Author(s):  
Rafael Neiman ◽  
Brian Maiocco ◽  
Vincent F. Deeney

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