scholarly journals SUPRACONDYLAR FRACTURE IN CHILDREN TREATED BY CLOSED REDUCTION AND INTERNAL FIXATION WITH K-WIRES

2016 ◽  
Vol 5 (02) ◽  
pp. 135-140
Author(s):  
Pereddy Somashekhara Reddy ◽  
Subhash Ushakoyala
2021 ◽  
Vol 20 (2) ◽  
pp. 32-36
Author(s):  
Tafhim Ehsan Kabir ◽  
ANM Humayun Kabir ◽  
Alak Kanti Biswas ◽  
Rahma Binte Anwar ◽  
Touhidul Islam ◽  
...  

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


2018 ◽  
Vol 1 (1) ◽  
pp. 1-3
Author(s):  
Bhogendra Bahadur KC ◽  
Norman Lamichhane ◽  
Chandra Bahadur Mishra ◽  
Bharat Bahadur Khatri ◽  
Sabita Dhakal

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.


Author(s):  
Shobha H. P. ◽  
Vishwas K. ◽  
Lingaraju K. ◽  
Giridhar Kumar

<p><strong>Background: </strong>To evaluate results of open reduction and internal fixation with Criss cross k-wires after failed closed reduction in Gartland type III Supracondylar fracture of humerus in our institution.<strong></strong></p><p><strong>Methods:</strong> This prospective study was conducted at the Krishna Rajendra hospital affiliated to the orthopaedic department of Mysore medical college and research institute from December 2018 to December 2019. Twenty-five patients of type-III fracture of supracondylar humerus were included within the study. Consent was obtained from all patients. Under anaesthesia, closed reduction was attempted first. When 2-3 attempts of closed reduction failed, an open reduction and internal fixation with cross k-wires was performed. Fortnightly follow up was applied for the first 8 weeks then monthly for the next 4 months. The clinical outcome was evaluated using Flynn criteria.</p><p><strong>Results:</strong> Out of 25 patients, 16 were male and 9 were female. Left side was involved in 17 patients and right side in 8. Mean age was 6.9 years with age range from 3 to 12 years. Excellent or good results were obtained in 23 (92%) patients and fair or poor in 2 (8%). </p><p><strong>Conclusions:</strong> We conclude that these fractures must be managed aggressively, by a specialised surgeon. Open reduction and internal fixation of severely displaced supracondylar fractures of the humerus is a safe and effective method when a satisfactory reduction can't be obtained by 2-3 attempts on closed method.</p>


Author(s):  
Ajay Kumar ◽  
Karthik Padmanabhan

<p class="abstract"><strong>Background:</strong> Injury to the supracondylar region of the humerus and complete displacement of the fragments occurs in many of the cases when children usually fall while playing. This is most common fracture seen in children, makes up to 60% of all elbow injuries. Early intervention results in excellent reduction and avoids complications. Concomitant vascular and nerve damages may occur. Open reduction and internal fixation is a helpful option for the treatment of supracondylar facture of humerus in children.</p><p class="abstract"><strong>Methods:</strong> Forty children who presented with displaced supracondylar fracture of the humerus were treated with open reduction and internal fixation with Kirschner (K) wires after thorough pre-operative investigation during the course of the study. Children below the age of 13 were selected irrespective of the sex.<strong></strong></p><p class="abstract"><strong>Results:</strong> Good results were obtained in 60% of the patients, fair in 30% and poor in 10%. The poor results were due to the open fracture and in two cases the patient presented very late to the hospital. Complications such as nerve injuries, vascular injuries, infections were noticed in the study. Four patients had cubitus varus and twelve patients had flexion loss on follow-up study.</p><p class="abstract"><strong>Conclusions:</strong> Open reduction and internal fixation with K wire is an easy, simple, inexpensive method, which has good outcome.</p>


2021 ◽  
Vol 33 (2) ◽  
pp. 138-142
Author(s):  
Md Insanul Alam ◽  
Sheikh Firoj Kabir ◽  
Md Faridul Islam ◽  
Md Ismail Hossain ◽  
Md Omar Faruque ◽  
...  

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


2012 ◽  
Vol 8 (1) ◽  
pp. 13-17
Author(s):  
HK Gupta ◽  
KD Khare ◽  
D Chaurasia

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


Author(s):  
Nilesh Janardan Keche ◽  
Abhijit Bhimrao Kale ◽  
Binoti Arun Sheth ◽  
Ashok Kumar Rathod

<p class="abstract"><strong>Background:</strong> Supracondylar fractures of the humerus are the most common elbow fracture in children of the age group 4-12 years. The modern approach for its treatment includes closed reduction or open reduction and internal fixation with K wires. The aim of the present study was to evaluate the clinical and radiological results of children who were treated with the two surgical approaches<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> In our institute children who underwent surgical treatment for supracondylar humeral fractures by closed reduction or open reduction and internal fixation with K wires and whose data were available with regular follow-up of at least 1 year were included in the study. Each group included 25 children in each. Clinical and radiological outcomes were evaluated and compared among the study groups.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age of the patients in both the groups were 6.84 and 6.64 in group 1 and group 2 respectively. Fractures were more in boys compared to girls in both the groups. Most of the fractures were seen on left side with posteromedial displacement of distal fragment in almost 80% in both the groups. Mean change in Baumann’s angle (BA), carrying angle and range of motion (ROM) as compared to normal side in both the groups after 3<sup>rd</sup> and 9<sup>th</sup> month of follow ups was found to be not statistically significant. Overall result according to Flynn’s criteria was 60% excellent in group 1 as compared to 52% in group 2. Mean satisfaction score was also more in group 1 children when compared to group 2<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Closed reduction with internal fixation with K wires was found to be a better choice of treatment with good functional results<span lang="EN-IN">.</span></p>


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