Treatment of the Displaced Supracondylar Fracture of the Humerus (Type III) with Closed Reduction and Percutaneous Cross-Pin Fixation

1991 ◽  
Vol 11 (6) ◽  
pp. 705-711 ◽  
Author(s):  
William L. Mehserle ◽  
Peter L. Meehan
Keyword(s):  
Closed Reduction ◽  
Supracondylar Fracture ◽  
Type Iii ◽  
Pin Fixation

scholarly journals Evaluation of Gartland Type-III Closed Supracondylar Fracture of Humerus in Children Treated by Lateral Percutaneous K-Wires under C-Arm Guidance

2021 ◽  
Vol 33 (2) ◽  
pp. 138-142
Author(s):  
Md Insanul Alam ◽  
Sheikh Firoj Kabir ◽  
Md Faridul Islam ◽  
Md Ismail Hossain ◽  
Md Omar Faruque ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Elbow Flexion ◽  
Supracondylar Fracture ◽  
Type Iii ◽  
Median Nerve Palsy ◽  
Pin Fixation ◽  
Number Of Patients ◽  
Quasi Experimental ◽  
Carrying Angle ◽  
K Wires

Introduction: This study has been designed to evaluate the success rate of closed reduction and stabilization by two lateral parallel percutaneous K-wires with the help of C-arm in the management of Gartland type-III closed supracondylar fracture of humerus in children. Materials and Methods: A prospective quasi experimental study was conducted from January 2015 to December 2016 in NITOR. A total of 30 patients of Gartland type-III closed supracondylar fracture of humerus in children presenting between ages 3-12 years. Informed written consent was taken from patient’s guardian. Regular follow up was targeted for at least 6 month’s. Result was evaluated according to Flynn’s grading. Results: Mean age was 6.85± 2.37 years, number of patients ware 30, Male patients were more affected 22 (73.33%) than female 8(26.67%), left side patients were more affected. Mean loss of elbow flexion was 9.53 degrees, mean loss of carrying angle was 8.5 degrees. Complications included four (13.33%) cases of pin tract infection, four (13.33%) cases of fracture blister, one (3.33%) case of median nerve palsy, two (6.66%) cases of inadequate pin fixation at first attempt. There were six excellent (20%), eighteen good (60%), three (10%) fair and three (10%) poor results according to Flynn’s grading. The overall 90% satisfactory result and rest 10% unsatisfactory result. Conclusion: Closed reduction and stabilization by two lateral parallel percutaneous K-wires is a better method for treatment of Gartland type-III closed supracondylar fracture in children. Medicine Today 2021 Vol.33(2): 138-142

scholarly journals Comparison of outcome of closed reduction and percutaneous pinning and, open reduction and internal fixation with k-wire in Gartland extension type III supracondylar fracture of distal humerus in pediatric population

2018 ◽  
Vol 1 (1) ◽  
pp. 1-3
Author(s):  
Bhogendra Bahadur KC ◽  
Norman Lamichhane ◽  
Chandra Bahadur Mishra ◽  
Bharat Bahadur Khatri ◽  
Sabita Dhakal
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Closed Reduction ◽  
Open Reduction ◽  
Operative Procedure ◽  
Distal Humerus ◽  
Supracondylar Fracture ◽  
P Value ◽  
Percutaneous Pinning ◽  
Type Iii

Background: Supracondylar fracture of the distal humerus is one of the commonest fracture in pediatric age group. Though there is consensus of treating type III fracture operatively, no study has compared the outcome between Closed Reduction and Percutaneous Pinning (CRPP) and Open Reduction and Internal Fixation (ORIF) with k-wire in our setup. Materials and Methods: Retrospective comparison study was done on eighty seven cases of Type III supracondylar fracture of distal humerus underwent operative procedure. Fifty four (54) cases underwent CRPP and 33 cases were managed with ORIF with k-wire, and they were followed up till 6 months post-operatively. Results : The mean time for radiological union in patient who underwent CRPP was 4.37±0.94 weeks and that for the patient who underwent ORIF was 4.45±0.13 weeks, the difference of which was statistically insignificant (p-value >0.05). 83.3% of CRPP group and 78.8% in ORIF group had excellent functional outcome and only 3% in ORIF group had poor functional outcome. Conclusion: Though both the group don’t have significant advantage of functional outcome among each other CRPP with limited attempt should be preferred to ORIF with k-wire for the advantage of avoiding surgical scar and reducing surgery time and exposure to anaesthetic agents.

scholarly journals Treatment outcome of gartland type III supracondylar fracture humerus in children with closed reduction and percutaneous pinning

2016 ◽  
Vol 2 (3) ◽  
pp. 95
Author(s):  
P. Thomas George ◽  
Mithun Joy Kattoor ◽  
Samson Samuel Edayalamuriyil
Keyword(s):  
Closed Reduction ◽  
Recovery Period ◽  
Varus Deformity ◽  
Functional Results ◽  
Supracondylar Fracture ◽  
Percutaneous Pinning ◽  
Type Iii ◽  
Medical College ◽  
Pin Tract Infection ◽  
Fracture Humerus

<p class="abstract"><strong>Background:</strong> Treatment of Gartland’s type III supracondylar fracture of humerus in children is one of the most challenging one. Conservative management usually results in deformity. On the other hand open reduction and internal fixation is a more invasive surgical method with a long recovery period. Thus, this study presents cases treated by closed reduction and percutaneous pinning and discussed its anatomical results, functional results and lastly its complications.</p><p class="abstract"><strong>Methods:</strong> Twenty five cases were treated with closed reduction and percutaneous pinning at Pushpagiri Medical College.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of the 25 patients studied, 24 (96%) had satisfactory results according to Modified Flynn’s criteria and there was only one case of superficial pin tract infection with no cases of cubitus varus deformity.</p><strong>Conclusions:</strong> This study presents that closed reduction and percutaneous pinning is a very good modality of treatment of Gartland type III fractures of humerus in children with very few complications.

scholarly journals Functional and Radiological Outcome of Type ΙΙΙ Supracondylar Fracture of Humerus Treated by Crossed Versus Lateral Pinning a Prospective Cohort Study Conducted in a Tertiary Health Care Centre in Thiruvananthapuram, Kerala

2021 ◽  
Vol 8 (26) ◽  
pp. 2300-2305
Author(s):  
Anand Narayanan ◽  
Subramanian Vaidyanathan
Keyword(s):  
Cohort Study ◽  
Functional Outcome ◽  
Prospective Cohort Study ◽  
Closed Reduction ◽  
Prospective Cohort ◽  
Supracondylar Fracture ◽  
Percutaneous Pinning ◽  
Pin Fixation ◽  
Significant Difference ◽  
Carrying Angle

BACKGROUND Supracondylar fracture of humerus is a common fracture in children. Closed manipulative reduction and percutaneous K-wire fixation is the most widely recognized treatment method for displaced supracondylar humerus fracture in children but controversy persists regarding the ideal pin fixation technique. The purpose of this study was to compare the radiological and functional outcome of lateral entry pinning with that of crossed pinning fixation for Gartland type III supracondylar humerus fractures in children. METHODS This prospective cohort study was conducted in Govt. Medical College Hospital, Thiruvananthapuram from February, 2015 to September, 2016. A total of 54 patients who satisfied the inclusion and exclusion criteria were enrolled in the study. They were allocated to Group A (crossed pin fixation) and Group B (lateral pin) fixation with 27 patients in each. All the cases of percutaneous pinning were done according to a uniform standardized technique. The patients were reevaluated at post-operative day, three weeks, and three months after the surgery. Following information were recorded as outcome measures: (i) carrying angle (ii) range of motion (iii) modified Flynn’s criteria. (v) Baumann’s angle (vi) neurovascular injury. RESULTS There was no statistically significant difference between crossed and lateral pinning with regard to mean Baumann's angle, carrying angle, complication rate, stability and functional outcome, but there was evidence of iatrogenic ulnar nerve injury (3.7 %) in crossed pinning group. There was one case of pin tract infection. CONCLUSIONS There is no statistically significant difference between the radiological and functional outcome provided by crossed pin fixation method and lateral pin fixation methods. Closed reduction and percutaneous pin fixation are safe and efficient methods for fixation of displaced supracondylar fractures of the humerus. Closed reduction and percutaneous pin fixation for displaced supracondylar factures of the humerus in children gives good functional and cosmetic results. KEYWORDS Humerus, Percutaneous Pinning, Supracondylar Fracture

scholarly journals Ipsilateral Supracondylar Fracture and Forearm Bone Injury in Children: A Retrospective Review of Thirty one Cases

2012 ◽  
Vol 9 (2) ◽  
pp. 11-16 ◽  
Author(s):  
D Dhoju ◽  
D Shrestha ◽  
N Parajuli ◽  
G Dhakal ◽  
R Shrestha
Keyword(s):  
Bone Fracture ◽  
Closed Reduction ◽  
Supracondylar Fracture ◽  
Radius Fracture ◽  
Type I ◽  
Type Iii ◽  
Bone Injury ◽  
Wire Fixation ◽  
Forearm Bone ◽  
Floating Elbow

Background Supracondylar fracture and forearm bone fracture in isolation is common musculoskeletal injury in pediatric age group But combined supracondylar fracture with ipsilateral forearm bone fracture, also known as floating elbow is not common injury. The incidence of this association varies between 3% and 13%. Since the injury is rare and only limited literatures are available, choosing best management options for floating elbow is challenging. Method In retrospective review of 759 consecutive supracondylar fracture managed in between July 2005 to June 2011, children with combined supracondylar fracture with forearm bone injuries were identified and their demographic profiles, mode of injury, fracture types, treatment procedures, outcome and complications were analyzed. Result Thirty one patients (mean age 8.91 yrs, range 2-14 yrs; male 26; left side 18) had combined supracondylar fracture and ipsilateral forearm bone injury including four open fractures. There were 20 (64.51%) Gartland type III (13 type IIIA and 7 type III B), seven (22.58 %) type II, three (9.67 %) type I and one (3.22 %) flexion type supracondylar fracture. Nine patients had distal radius fracture, six had distal third both bone fracture, three had distal ulna fracture, two had mid shaft both bone injury and one with segmental ulna with distal radius fracture. There were Monteggia fracture dislocation, proximal ulna fracture, olecranon process fracture, undisplaced radial head fracture of one each and two undisplaced coronoid process fracture. Type I supracondylar fracture with undisplaced forearm were treated with closed reduction and long arm back slab or long arm cast. Displaced forearm fracture required closed reduction and fixation with Kirschner wires or intramedullary nailing. Nineteen patients with Gartland type III fracture underwent operative intervention. Among them nine had closed reduction and K wire fixation for both supracondylar fracture and forearm bone injury. One patient with closed reduction and long arm cast application for both type III supracondylar fracture and distal third radius fracture developed impending compartment syndrome and required splitting of cast, remanipulation and Kirschner wire fixation. There were three radial nerve, one ulnar nerve and one median nerve injury and two postoperative ulnar nerve palsy. Three patients had pin tract related complications. Among type III, 16 (80%) patients had good to excellent, two had fair and one gad poor result in terms of Flynn’s criteria in three months follow up ConclusionDisplaced supracondylar fracture with ipsilateral displaced forearm bone injuries need early operative management in the form of closed reduction and percutaneous pinning which provides not only stable fixation but also allows close observation for early sign and symptom of development of any compartment syndrome.DOI: http://dx.doi.org/10.3126/kumj.v9i2.6280 Kathmandu Univ Med J 2011;9(2):11-16 

scholarly journals Results of lateral pin fixation for the displaced supracondylar fracture of humerus in children

2012 ◽  
Vol 8 (1) ◽  
pp. 13-17
Author(s):  
HK Gupta ◽  
KD Khare ◽  
D Chaurasia
Keyword(s):  
Closed Reduction ◽  
Supracondylar Fracture ◽  
Satisfactory Outcome ◽  
Pin Fixation ◽  
Choice Of Treatment ◽  
Fixation Techniques ◽  
K Wires ◽  
Tract Infections ◽  
Displaced Fracture ◽  
Fracture Stability

Supracondylar fracture is common fracture in children and choice of treatment in displaced fracture is closed reduction and percutaneous pinning. There are different methods of fixation techniques described and practiced. This study was undertaken to evaluate the results of lateral pin fixation for the displaced supracondylar fracture of humerus in children. 25 children with displaced Supracondylar fracture were treated with closed reduction and percutaneous lateral fixation by two K-wires. Above elbow slab applied for 4 weeks (mean 28.4 days ± SD 2.27) followed by physiotherapy and were followed for mean of 73.24 days( ± SD 3.66 days). The Flynn’s grading system was used to evaluate functional and cosmetic outcome. Loss in Baumann’s angle was measures. All the patient had satisfactory outcome with excellent to good grading as per Flynn’s criteria. The mean Baumann’s angle loss was 5.52 degrees(SD ± 1.75). Two pin tract infections noted which responded to oral cloxacillin for 5 days. No neurovascular or serious complication noted. In view of results obtained, lateral K -wire fixation provided good fracture stability, good union and satisfactory outcome with minimal complication and virtually no iatrogenic nerve injury. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-1, 13-17 DOI: http://dx.doi.org/10.3126/jcmsn.v8i1.6820

scholarly journals Surgical Management of Supracondylar Fractures of the Humerus in Children by Closed Reduction and Percutaneous Pinning with Kirschnner Wires-A Cross-sectional Study

2021 ◽  
Author(s):  
Chavan Pramod Babu ◽  
K Shankara ◽  
T Lakshmeesha
Keyword(s):  
Closed Reduction ◽  
Statistical Tests ◽  
Excellent Result ◽  
Cross Sectional Study ◽  
Supracondylar Fracture ◽  
Percutaneous Pinning ◽  
Sectional Study ◽  
Supracondylar Fractures ◽  
Cross Sectional ◽  
Type Iii

Introduction: Supracondylar Humerus Fracture (SCHF) is frequently encountered in paediatric age group and constitutes nearly three fourth of all upper extremity fractures. Most commonly used technique for surgical treatment in the displaced SCHF in children is closed reduction and stabilisation with percutaneous pins. Aim: To find out the outcome and safety of percutaneous pinning techniques in terms of functional and radiological outcome and to note the associated complications with this method of fixation. Materials and Methods: This was a cross-sectional study, conducted on patients admitted to Department of Orthopaedics, Hassan Institute of Medical Sciences, Hassan, between January 2017 to December 2019. Thirty paediatric cases were retrospectively reviewed. These were admitted with a supracondylar fracture and had reported to the hospital over a three-year period. All fractures were treated with closed reduction and fixation with percutaneus K-wire followed by immobilisation in above elbow slab for three weeks. K-wires were removed at three weeks and mobilisation with physiotherapy was advised. Outcome was measured by Flynn’s Criteria. The results were analyzed as per appropriate descriptive statistical tests. Results: The mean age of the patients was 7.4 years (range 3-15years). Males outnumbered females. Total 22 (73.3%) patients had left-sided fracture and 8 (26.6%) had fracture on right side. Fracture union was seen in all the patients at a mean interval of 4.2 weeks (range 3-5 weeks), in a follow up of 12 weeks. Most (90%) of the injuries were the result of trauma, including fall. 70% of the fractures were Gartland Type III supracondylar fracture. Cross K- wire fixation was done in 21 patients and lateral-only pin in 9 patients. Among the 21 patients, who had type III fracture, 4 of them were fixed with 2 Lateral K- wire pinning and 17 of them with crossed K-wire pinning configuration. The commonest post-operative complication observed was a superficial pin tract infection, seen in 4 (13.3%) patients. Outcome according to the Flynn’s criteria 25 patients (83.3%) had excellent result, 3 (10%) patients had good result, 1 (3.3%) had fair result and 1 (3.3%) patient had poor functional result. Conclusion: The present study concludes that close reduction and percutaneous k-wire pinning techniques give a favorable outcome in displaced supracondylar fractures of the humerus in children, without any serious complications.

scholarly journals Treatment Result Following Fluoroscopic Guided Close Reduction and Internal Fixation by Per-Cutaneous Crossed K-Wires of Extension Type Gartland Type-II and Type-III Supracondylar Fracture of Humerus in Children

2021 ◽  
Vol 20 (2) ◽  
pp. 32-36
Author(s):  
Tafhim Ehsan Kabir ◽  
ANM Humayun Kabir ◽  
Alak Kanti Biswas ◽  
Rahma Binte Anwar ◽  
Touhidul Islam ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Closed Reduction ◽  
Supracondylar Fracture ◽  
Treatment Result ◽  
Type Ii ◽  
Supracondylar Fractures ◽  
Female Ratio ◽  
Type Iii ◽  
K Wires ◽  
Tract Infections

Background : Supracondylar fractures of the humerus is one of the most common fractures in children. Failure to treat properly leads to malunion of the fracture site. For that, closed reduction and percutaneous pinning is considered to be the golden choice for treatment. There are many methods in which percutaneous k-wire fixation can be done. The aim of this study is to report the advantages of percutaneous fixation using cross pinning from both medial and lateral sides. Materials and methods : A total number of seventy pediatric patients with Gartland type II and type III supracondylar fracture of the humerus were recruited from the outpatient department of two different hospitals between January 2018 and September 2020. All of them were treated using closed reduction and internal fixation using percutaneous crossed k-wires. The treatment outcomes were evaluated using Flynn’s criteria and were compared with other similar studies. Results : The mean age of study subjects was 8.14 ± 2.8 and the male to female ratio was 1.6:1. In 27(38.6%) cases the left arm was involved while in 43(61.4%) cases the right arm was involved. Preoperative complications included 1(1.4%) case with radial nerve palsy and 4(5.7%) cases with pulseless pink hand. When evaluating cosmetic outcome using Flynn’s criteria, there were 57(81.4%) excellent, 10(14.3%) good and 3(4.3%) fair outcomes. On evaluating outcome according to range of motion deficit outcomes were excellent in 35(50%), good in 22(31.4%), fair in 5(7.2%) and poor in 8(11.4%) children. Post-operative complications were 1(1.4%) ulnar nerve neuropraxia and 5(7.2%) superficial pin tract infections. Conclusion : Closed reduction and internal fixation using percutaneous crossed kwires placed from the medial and lateral side gives satisfactory cosmetic and functional outcomes in majority of the patients with Gartland type II and III supracondylar fractures of the humerus. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 32-36

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