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

2019 ◽  
Vol 5 (3) ◽  
pp. 427
Author(s):  
Putappa Gopinath ◽  
Sabneet Singh ◽  
Abdul Ravoof
Keyword(s):  
Functional Outcome ◽  
Closed Reduction ◽  
Distal Humerus ◽  
Percutaneous Pinning ◽  
Supracondylar Fractures ◽  
Anatomical Reduction ◽  
Fractures In Children ◽  
Wire Fixation ◽  
Carrying Angle ◽  
Loss Of Motion

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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.<strong></strong></p><p class="abstract"><strong>Results:</strong> 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.</p><p class="abstract"><strong>Conclusions:</strong> 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.</p>

scholarly journals Closed Reduction and Percutaneous Pinning in the Treatment of Humeral Distal Metaphyseal-Diaphyseal Junction Fractures in Children: A Technique Note and Preliminary Results

2021 ◽  
Vol 9 ◽  
Author(s):  
Hai Zhou ◽  
Ge Zhang ◽  
Ming Li ◽  
Xing Liu ◽  
Xiangyang Qu ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Open Reduction ◽  
Distal Humerus ◽  
The Novel ◽  
Percutaneous Pinning ◽  
Supracondylar Fractures ◽  
Radiographic Outcomes ◽  
Fractures In Children ◽  
Group A ◽  
Group B

Objective: The metaphyseal-diaphyseal junction (MDJ) fracture is an uncommon but problematic type of fracture occurring at the distal humerus in children. Closed reduction and fixation are challenging and may not be possible with the conventional reduction maneuver utilized in supracondylar fractures. The purpose of this study was to evaluate a novel closed reduction and percutaneous pinning (CRPP) technique for the treatment of these fractures.Methods: We retrospectively evaluated 14 children (8 boys and 6 girls) who underwent closed reduction and percutaneous fixation for the treatment of MDJ fractures. Six children who underwent treatment with a novel CRPP technique were enrolled as Group A. Eight children underwent the conventional reduction maneuver utilized in supracondylar fracture and were enrolled as Group B. Clinical and radiographic outcomes in the two groups were then compared.Results: In Group A, all six MDJ fractures were treated successfully with the novel CRPP technique without the need for open procedures or re-operation. No complications such as pin-site infection or iatrogenic nerve injury were found in this group. In group B, five of the eight fractures were treated successfully with the conventional CRPP technique; three fractures needed open reduction, and one of them had further surgery because of the loss of fixation. Children with successful CRPP in each group were included to compare the efficacy of the novel CRPP technique. The average duration of the surgery in Group A was significantly shorter than that in Group B (p &lt; 0.001). At last follow-up, both groups obtained satisfactory clinical and radiographic outcomes.Conclusion: MDJ fractures can be reduced successfully and fixed stably via a novel CRPP technique, and laborious and frustrating attempts at closed reduction and further open reduction can be avoided.

FUNCTIONAL OUTCOME OF CLOSED DISPLACED SUPRACONDYLAR FRACTURE OF HUMERUS IN CHILDREN TREATED WITH CLOSED REDUCTION AND PERCUTANEOUS PINNING – A PROSPECTIVE OBSERVATIONAL STUDY

2021 ◽  
pp. 9-11
Author(s):  
Sandeep Ramola ◽  
Prasanth Srinivasan ◽  
Vidyanand M Makani
Keyword(s):  
Observational Study ◽  
Functional Outcome ◽  
Closed Reduction ◽  
Prospective Observational Study ◽  
Supracondylar Fracture ◽  
Elbow Fracture ◽  
Percutaneous Pinning ◽  
Supracondylar Fractures ◽  
Supracondylar Humeral Fractures ◽  
Carrying Angle

Background: Supracondylar humeral fractures are the most common fractures around elbow in children. The incidence is equal in both sexes with left or non-dominant side being most frequently injured. 96 to 98% are extension type and the exion type is far less common. Displaced supracondylar fractures are notorious for difculty in reduction, maintenance of reduction and frequent involvement of neurovascular structures. Material and methods: A prospective observational study was conducted on sixty children with closed displaced supracondylar fracture of humerus treated with closed reduction and k wire xation, between May 2016 and June 2018. Children aged between 3 and 15 years, radiological nding conrming displaced supracondylar fracture of humerus were included in this study. Children with less than 3 years of age, physeal injury or intraarticular extension, open fractures, polytrauma of the same limb, previous fracture of the same elbow, fracture requiring open reduction and inability to give written informed consent were excluded in this study. All patients underwent closed reduction and percutaneous pinning within 24 hours of admission. The functional outcome was measured by the range of motion and carrying angle by using Flynn et al criteria. Results: Of 60 patients, 73.3% had excellent results, 18.3% had good, 5% had fair and 3.3% patients had poor results. Conclusion: Closed reduction and percutaneous pinning under C arm guidance is a simple and effective method of treatment of displaced supracondylar fractures of humerus in children with relatively fewer short term complications.

scholarly journals Functional outcome of crossed Kirschner wire fixation in pediatric supracondylar humerus fracture

2019 ◽  
Vol 5 (5) ◽  
pp. 772
Author(s):  
Rahat Zahoor Moton ◽  
Adeel Ahmed Siddiqui ◽  
Muhammad Naseem ◽  
Uzair Yaqoob ◽  
Syed Amir Jalil ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Kirschner Wire ◽  
Humeral Fractures ◽  
Treatment Modalities ◽  
Class Iii ◽  
Supracondylar Fractures ◽  
Fractures In Children ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Supracondylar Humeral Fractures

<p class="abstract"><strong>Background:</strong> Distal humeral fractures are one of the most common types of fractures in children, most of them being supracondylar. Supracondylar fractures are usually caused by trauma, most likely falls. It is an emergency, requiring rapid diagnosis and management to avoid serious complications. Recommended treatment modalities vary from no reduction and immobilization to open reduction and internal fixation. Kirschner wire (K-wire) fixation of displaced supracondylar fractures after closed reduction is a preferred method and is being performed for over 50 years now. This study was conducted to determine the functional outcome of crossed K-wire fixation in pediatric supracondylar fracture.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted from May-November 2018 at the department of Orthopedics, Abbasi Shaheed Hospital, Karachi, Pakistan. It was inferred that functional outcome of pediatric displaced supracondylar humeral fractures is satisfactory when managed with percutaneous crossed K-wire fixation. It included 83 children with supracondylar fractures. They were treated with percutaneous crossed K-wire fixation. Patients were then followed up to determine satisfactory functional outcome according to Flynn’s criteria. Data entry and analysis was done using SPSS 21.0.</p><p class="abstract"><strong>Results:</strong> Eight-three patients were included. The mean±standard deviation age of this study population was 7.03±3.39 years. Out of the study participants, 47 (56.6%) were males and 36 (43.4%) were females. 71.1% of the patients were of Gartland class II fractures and 28.9% were of Gartland class III. 43.4% had an injury due to fall while playing while 19.3% had fallen from height. 80.7% were found to have a satisfactory functional outcome.</p><p class="abstract"><strong>Conclusions:</strong> It was inferred that the functional outcome of pediatric displaced supracondylar humeral fractures is satisfactory when managed with percutaneous crossed K-wire fixation.</p>

scholarly journals Conservative management of displaced paediatric supracondylar fractures: a systematic review

2018 ◽  
Vol 48 (4) ◽  
pp. 359-365 ◽  
Author(s):  
Daniel Yeomans ◽  
Simon M Graham ◽  
Nyengo C Mkandawire ◽  
William J Harrison ◽  
Daniel C Perry
Keyword(s):  
Systematic Review ◽  
Low Income ◽  
Closed Reduction ◽  
Distal Humerus ◽  
Low Income Countries ◽  
Supracondylar Fractures ◽  
Middle Income ◽  
Fractures In Children ◽  
Published Evidence ◽  
Few Data

In low-income countries, where surgical expertise and resources are limited, displaced supracondylar fractures of the distal humerus are routinely managed with traction or closed reduction and casting. This is in contrast to high-income nations, where percutaneous K-wire fixation forms the mainstay of treatment. The aim of our study is to present the published evidence regarding the outcome of conservatively managed displaced supracondylar fractures in children. A systematic review of the literature was performed identifying 46 studies evaluating the outcome of displaced supracondylar fractures managed non-operatively. Our results show management by traction is equivalent to percutaneous pinning, whereas outcomes following closed reduction and casting were inconsistent. Traction therefore remains a viable option in low- and middle-income countries (LMICs). However, at present there are few data from LMICs, limiting the transferability of our conclusions.

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 Close Reduction and Percutaneous K-wire Fixation without Image Intensifier in Supracondylar Fracture of Humerus in Children

2013 ◽  
Vol 3 (1) ◽  
pp. 19-22
Author(s):  
Ruhullah Mohammad ◽  
Sanjay Kumar Ranjan Shah ◽  
HR Singh ◽  
KD Sinha ◽  
Dipan Barua ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Case Series ◽  
Image Intensifier ◽  
Cost Effective ◽  
Percutaneous Pinning ◽  
Supracondylar Fractures ◽  
Gold Standard Method ◽  
Remote Hospital ◽  
Wire Fixation ◽  
One Year

Introduction: Extension Type III supracondyla fractures of the humerus is most common fractures around the elbow in children. Closed reduction and percutaneous pinning under image intensifier guide has been the gold standard method of treatment. However, image intensifier is not readily available in most part of our country. Closed reduction and percutaneous pinning is possible even without image intensifier. we report our case series of 51 cases who underwent closed reduction and percutaneous pinning without image intensifier. Methods: Between November 2009 and April 2011 a total of 51 children with a displaced supracondylar fractures of the humerus were managed by close reduction and percuteneus k-wire fixation without using image intensifier. They were followed for a period of minimum 6 months up to one and a half years (average one year) and the final outcome was assessed using functional and cosmetic criteria used by Flynn and associates. Results: Of these 51 patients, 46 (90%) patients showed an excellent results. Satisfactory results were achieved in 4 (8%) patients, poor in 1(2%) patients. Conclusion: Close reduction and percutaneous K-wire fixation without using image intensifier is radiation free, cost effective and relatively safe method of management of displaced supracondylar fractures of humerus in children. It can be used in a remote hospital where the facilities of image intensifier or portable x-ray are not available. DOI: http://dx.doi.org/10.3126/noaj.v3i1.9321 Nepal Orthopedic Association Journal 2013 Vol.3(1): 19-22

scholarly journals Study of Supracondylar Fracture of Distal Humerus in Children and Its Management with Lateral K-Wire Fixation

2014 ◽  
Vol 3 (1) ◽  
pp. 38-43
Author(s):  
K Sapkota ◽  
B Shrestha
Keyword(s):  
Excellent Result ◽  
Distal Humerus ◽  
Supracondylar Fracture ◽  
P Value ◽  
Lateral Column ◽  
Fractures In Children ◽  
Significant Difference ◽  
Wire Fixation ◽  
Carrying Angle ◽  
K Wires

Background: Supracondylar fracture is one of the common fractures in children. There are different methods of treatment. This study was undertaken to evaluate the results of lateral k wire fixation for the displaced supracondylar fracture of distal humerus in children. Methods: There were 32 children with displaced Supracondylar fracture, treated with closed reduction and percutaneous lateral K-wires fixation. Clinical and radiological assessments were done and outcomes were assessed on basis of Flynn criteria and data were analyzed in SPSS 16. P value <0.05 was considered significant. Result: The mean age of patients was 6.41 ± 2.37 with boys predominant. There were excellent result of 24(75%) good result 5(15%) regarding carrying angle and regarding range of motion 25 (78%) excellent and4(12%) good result. There were more than 90% patients with excellent to good result. Comparing the Baumann’s angle intra-operatively and at the final follow up, there was no statistically significant difference with P value > 0.05. Conclusion: Lateral pinning with 2 and if necessary 3 k wires for proper stabilization and idea configuration of divergent to hold medial and lateral column is the ideal treatment of supracondylar fracture without risk of iatrogenic nerve injury. Nepal Journal of Medical Sciences | Volume 03 | Number 01 | January-June 2014 | Page 38-43 DOI: http://dx.doi.org/10.3126/njms.v3i1.10356

scholarly journals Outcome of Supracondylar Fractures of the Humerus in Children Treated by Closed Reduction and Percutaneous Pinning

2008 ◽  
Vol 47 (170) ◽  
Author(s):  
Pramod Devkota ◽  
JA Khan ◽  
BM Acharya ◽  
NMS Pradhan ◽  
LP Mainali ◽  
...  
Keyword(s):  
Tract Infection ◽  
Closed Reduction ◽  
Percutaneous Pinning ◽  
Supracondylar Fractures ◽  
Treatment Results ◽  
Wire Fixation ◽  
Ulnar Nerve Injury ◽  
K Wires ◽  
Pin Tract Infection

Supracondylar fractures of humerus in children are common injuries. Displaced fractures areinherently unstable. Conservative treatment results in malunion. Open reduction and internalfixation (ORIF) is more invasive and recovery is prolonged. From September 2004 to September 2005, 102displacedsupracondylarfractures of humerus, agedbetween one andhalf yearto 13 years, weretreated using close reduction and percutaneous Kirschner (K) wire fixation under c-arm fluoroscopy. Seventy nine patients were treated by cross K-wires and in twenty three cases lateral two K-wireswereput.Above elbow plaster ofparis back slab was appliedinall cases for atleastfour weeks.Backslab,K-wireswere removedafterfourweeks andelbowrangeofmotionexercisewas started.Resultswere analyzed using Flynn’s criteria. All patients were followed up to 14th week postoperatively. Incross K-wire group(N=79) 70.8% had excellent, 22.7% good, 3.8% fair and 2.5% had poor results at eight weeks follow up which was improved to 91.1% excellent, 6.3 good, 1.2% fair and 1.26% poor results at 14 weeks follow up. In lateral K-wire group (N=23) 70% had excellent, 21.7% good, 4.3% fair and 4.3% had poor result at eighth week which was improved to 91.3% excellent, 4.3% good, 4.3% fair and no poor result at 14th week follow up. Eight patients got superficial pin tract infection and seven patients sustained ulnar nerve injury post operatively.We recommend this procedure fordisplacedsupracondylarfractures inchildrenas itis safeandcost effectiveprocedurewithacceptablecomplication rates.Key words: closed reduction, humerus, percutaneous pinning, supracondylar fracture

scholarly journals SUPRACONDYLAR FRACTURE OF HUMERUS;

2012 ◽  
Vol 19 (03) ◽  
pp. 308-311
Author(s):  
WASIM ANWAR ◽  
Mohammad SIRAJ ◽  
NOOR RAHMAN ◽  
Malik Javed Iqbal ◽  
Israr Ahmad ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Supracondylar Fracture ◽  
Cubitus Varus ◽  
Supracondylar Fractures ◽  
Injured Side ◽  
Fractures In Children ◽  
The Mean ◽  
Carrying Angle ◽  
One Year

Objectives: To assess closed reduction by Baumann angle in supracondylar fractures humerus treated by closed reduction andpercutaneous pinning. Material and Methods: This prospective study of 50 patients who presented with displaced supracondylar fracture ofhumerus in children between ages 1-12 years were admitted to Orthopedic and Trauma unit of Hayatabad Medical Complex Peshawar overperiod from January 2008 to July 2009. Closed reduction and percutaneous pinning were performed under general anesthesia and postoperativereduction was assessed by Baumann angle. All patients were followed for one year. Results: Mean age of the patients was 7.02 years± 2.25 SD. Loss of Baumann angle in injured side was range from 2O to 8O. Loss of carrying angle in injured side was range from 3O to 9O. WhenBaumann angle and carrying angle of both sides were compared the mean Baumann angle loss and carrying angle loss were 5.360 ± 2.22 SDand 4.320 ± 1.52 SD respectively. Using Flynn’s criteria 36 (72%) patients out of 50 patients with carrying-angle loss considered to be excellentresults and 14(28%) good results. Neither of the patient developed cubitus varus deformit y after one year of follow-up. Conclusions: Baumannangle of the humerus is a simple and reliable measurement of closed reduction that can be used to predict final carrying angle in supracondylarhumeral fractures in children.

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