scholarly journals The results of closed reduction and percutaneous pinning in supracondylar fractures of humerus in children

2018 ◽  
Vol 4 (3.1) ◽  
pp. 27-30
Author(s):  
Mohd Irfan Banday ◽  
Jabreel Muzaffar
2013 ◽  
Vol 3 (1) ◽  
pp. 19-22
Author(s):  
Ruhullah Mohammad ◽  
Sanjay Kumar Ranjan Shah ◽  
HR Singh ◽  
KD Sinha ◽  
Dipan Barua ◽  
...  

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


2008 ◽  
Vol 47 (170) ◽  
Author(s):  
Pramod Devkota ◽  
JA Khan ◽  
BM Acharya ◽  
NMS Pradhan ◽  
LP Mainali ◽  
...  

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


2021 ◽  
Vol 9 ◽  
Author(s):  
Hai Zhou ◽  
Ge Zhang ◽  
Ming Li ◽  
Xing Liu ◽  
Xiangyang Qu ◽  
...  

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 < 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.


2021 ◽  
pp. 9-11
Author(s):  
Sandeep Ramola ◽  
Prasanth Srinivasan ◽  
Vidyanand M Makani

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.


1983 ◽  
Vol &NA; (177) ◽  
pp. 203???209 ◽  
Author(s):  
JEFFREY L. NACHT ◽  
MALCOLM L. ECKER ◽  
STANLEY M. K. CHUNG ◽  
PAUL A. LOTKE ◽  
MARIANNE DAS

Author(s):  
Putappa Gopinath ◽  
Sabneet Singh ◽  
Abdul Ravoof

<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>


Author(s):  
Chavan Pramod Babu ◽  
K Shankara ◽  
T Lakshmeesha

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.


Sign in / Sign up

Export Citation Format

Share Document