Introduction. Closed reduction and percutaneous pinning are the most widely
used treatment options for displaced supracondylar humerus fractures in
children, but there is still no consensus concerning the most preferred
technique in injuries of the extension type. Objective. The aim of this study
was to compare three common orthopaedic procedures in the treatment of
displaced extension type supracondylar humerus fractures in children.
Methods. Total of 93 consecutive patients (66 boys and 27 girls) referred to
our hospital with Gartland type II or III extension supracondylar humeral
fractures were prospectively included in the study over a six-year period. At
initial presentation 48 patients were classified as Gartland type II and 45
as Gartland type III fractures. The patients were subdivided into three
groups based on the following treatment modality: closed reduction with
percutaneous pinning, open reduction with Kirschner wires (K-wires) fixation,
and closed reduction with cast immobilisation. The treatment outcome and
clinical characteristics were compared among groups, as well as evaluated
using Flynn?s criteria. Results. Excellent clinical outcome was reported in
70.3% of patients treated with closed reduction with percutaneous pinning and
in 64.7% of patients treated with open reduction with K-wire fixation. The
outcome was significantly worse in children treated with closed reduction and
cast immobilisation alone, as excellent outcome is achieved in just 36.4% of
cases (p=0.011). Conclusion. Closed reduction with percutaneous pinning is
the method of choice in the treatment of displaced pediatric supracondylar
humeral fracture, while open reduction with K-wire fixation is as a good
alternative in cases with clear indications.
Assessment of elbow functional outcome after closed reduction and percutaneous pinning of displaced supracondylar humerus fractures in children
