scholarly journals Treatment Result Following Fluoroscopic Guided Close Reduction and Internal Fixation by Per-Cutaneous Crossed K-Wires of Extension Type Gartland Type-II and Type-III Supracondylar Fracture of Humerus in Children

2021 ◽  
Vol 20 (2) ◽  
pp. 32-36
Author(s):  
Tafhim Ehsan Kabir ◽  
ANM Humayun Kabir ◽  
Alak Kanti Biswas ◽  
Rahma Binte Anwar ◽  
Touhidul Islam ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Closed Reduction ◽  
Supracondylar Fracture ◽  
Treatment Result ◽  
Type Ii ◽  
Supracondylar Fractures ◽  
Female Ratio ◽  
Type Iii ◽  
K Wires ◽  
Tract Infections

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

scholarly journals Type-III supracondylar humerus fracture: functional outcome of open reduction and internal fixation after failed closed reduction

2020 ◽  
Vol 7 (1) ◽  
pp. 62
Author(s):  
Shobha H. P. ◽  
Vishwas K. ◽  
Lingaraju K. ◽  
Giridhar Kumar
Keyword(s):  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Supracondylar Fractures ◽  
Orthopaedic Department ◽  
Type Iii ◽  
Medical College ◽  
K Wires ◽  
Age Range

<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>

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 Evaluation of Gartland Type-III Closed Supracondylar Fracture of Humerus in Children Treated by Lateral Percutaneous K-Wires under C-Arm Guidance

2021 ◽  
Vol 33 (2) ◽  
pp. 138-142
Author(s):  
Md Insanul Alam ◽  
Sheikh Firoj Kabir ◽  
Md Faridul Islam ◽  
Md Ismail Hossain ◽  
Md Omar Faruque ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Elbow Flexion ◽  
Supracondylar Fracture ◽  
Type Iii ◽  
Median Nerve Palsy ◽  
Pin Fixation ◽  
Number Of Patients ◽  
Quasi Experimental ◽  
Carrying Angle ◽  
K Wires

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

scholarly journals Results of lateral pin fixation for the displaced supracondylar fracture of humerus in children

2012 ◽  
Vol 8 (1) ◽  
pp. 13-17
Author(s):  
HK Gupta ◽  
KD Khare ◽  
D Chaurasia
Keyword(s):  
Closed Reduction ◽  
Supracondylar Fracture ◽  
Satisfactory Outcome ◽  
Pin Fixation ◽  
Choice Of Treatment ◽  
Fixation Techniques ◽  
K Wires ◽  
Tract Infections ◽  
Displaced Fracture ◽  
Fracture Stability

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

scholarly journals Surgical Management of Supracondylar Fractures of the Humerus in Children by Closed Reduction and Percutaneous Pinning with Kirschnner Wires-A Cross-sectional Study

2021 ◽  
Author(s):  
Chavan Pramod Babu ◽  
K Shankara ◽  
T Lakshmeesha
Keyword(s):  
Closed Reduction ◽  
Statistical Tests ◽  
Excellent Result ◽  
Cross Sectional Study ◽  
Supracondylar Fracture ◽  
Percutaneous Pinning ◽  
Sectional Study ◽  
Supracondylar Fractures ◽  
Cross Sectional ◽  
Type Iii

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.

scholarly journals Supracondylar fracture, buried vs non buried K wires.

2020 ◽  
Vol 27 (03) ◽  
pp. 467-471
Author(s):  
Usama Bin Saeed ◽  
Muhammad Waseem ◽  
Allah Rakha Hassan ◽  
Zeeshan Ali Khan ◽  
Dilshad Gill ◽  
...  
Keyword(s):  
Tract Infection ◽  
Internal Fixation ◽  
Open Reduction ◽  
Supracondylar Fracture ◽  
Supracondylar Fractures ◽  
Elbow Fractures ◽  
Group A ◽  
K Wires ◽  
Pin Tract Infection ◽  
Group B

Supracondylar fracture of the humerus is the second most common fracture in children (16.6%), and is most common fracture around the elbow in children comprise (60%) to (75%) of all elbow fractures. There is very little data available about the burier of wires under the skin reduces the pin tract infection rate as low as 2.27%.2 Objectives: To compare the frequency of pin tract infection between nonburied and buried K-wires after open reduction internal fixation in supracondylar fracture of humerus in children. Study Design: Prospective Cohort Study. Setting: Department of Orthopedics Surgery & Traumatology Allied Hospital Faisalabad. Period: From June 2014 - June 2017. Material & Methods: Patients were selected according to the inclusion criteria. All patients were registered in ER with a history of trauma and having the diagnosis of Supracondylar fracture. Two groups were made; Group A (Buried), Group B (Non-buried). They were followed for the signs of infection. Results:  Out of 80 cases 45 (56.3 %) were male and 35 (43.8 %) female. In group A (non-buried) there were 40 patients and Mean age was 7.57± 2.07 years, pin tract were infected in 8 (20%) patients and there were no pin tract infection in 32 (80%) patients. And in group B (buried) there were 40 patients and mean age was 7.38± 2.17 years, Pin tract was infected in 1(2.5%) patient and there were no pin tract infection in 39(97.5%). Conclusion: Our study showed that rate of infection is significantly reduced in burying of K-wires after open reduction and internal fixation of supracondylar fractures as compared to non-burying technique.

scholarly journals A clinical study of closed reduction and percutaneous Kirschner wire fixation of displaced supracondylar fractures of humerus in children

2017 ◽  
Vol 3 (2) ◽  
pp. 282
Author(s):  
Mohammad Asimuddin ◽  
Raju H. Kulkarni
Keyword(s):  
Closed Reduction ◽  
Kirschner Wire ◽  
Fracture Pattern ◽  
Supracondylar Fractures ◽  
Female Ratio ◽  
Lateral Entry ◽  
Kirschner Wire Fixation ◽  
Supracondylar Humerus Fractures ◽  
Wire Fixation ◽  
K Wires

<p class="abstract"><strong>Background:</strong> Supracondylar fractures of the humerus are the most common fracture pattern of the elbow in children. Displaced supracondylar fractures are notorious for difficulty in reduction, maintenance of reduction and frequent involvement of neurovascular structures. The purpose of this study was to evaluate the results of stabilization of these fractures by closed reduction and percutaneous Kirschner wire fixation.</p><p class="abstract"><strong>Methods:</strong> Thirty cases of displaced supracondylar humerus fractures were included in the study. The mean age of the patient was 8.3 years [ranges from 4-14 years]. The male to female ratio was 2:1 and left side was involved in 23 cases whereas 7 had right sided injuries. All fractures were of extension type [Gartland’s type III]. Posteromedial displacement was noted in 22 cases whereas 8 fractures were posterolaterally displaced. In 20 cases, lateral entry wires alone were used whereas in 10 cases one lateral and one medial K-wire were used. K- wires were removed after 3 weeks post-operatively and follow-up was done at 6 weeks,12 weeks, 6 months and 12 months, when they  were evaluated according to Flynn’s criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> Results were graded using Flynn’s criteria. Excellent results were achieved in 18 [60%], good in 6 [20%] fair in 4 [13.3%], while poor results were seen in 2 [6.7%] patients.</p><p><strong>Conclusions:</strong> Closed reduction and percutaneous fixation using Kirschner wires is a safe and efficient method for fixation of displaced supracondylar fractures of the humerus in children. </p>

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