Functional outcome of displaced supracondylar fracture humerus in children treated by closed reduction and percutaneous pinning with Kirchner wires: An observational study

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.

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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

Medical Journal of Pokhara Academy of Health Sciences ◽

10.3126/mjpahs.v1i1.22449 ◽

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.

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

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20162782 ◽

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

Background: 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.Methods: Twenty five cases were treated with closed reduction and percutaneous pinning at Pushpagiri Medical College.Results: 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.Conclusions: 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.

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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

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/429 ◽

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

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