CLOSED REDUCTION AND PERCUTANEOUS FIXATION WITH CROSSED K-WIRES IN DISPLACED SUPRACONDYLAR FRACTURES OF HUMERUS

Displaced Supracondylar Fractures of Humerus

Abstract

Objective: To evaluate the out-come of closed reduction under image intensifier and percutaneous cross k-wire fixation in Gartland Type II and III supracondylar fractures of humerus in children.
Study Design: Case series
Place and Duration of Study: Combined Military Hospital Rawalpindi and Combined Military Hospital Malir, from Jun 2006 to Jan 2012.
Patients and Methods: Patients 3-10 years of age, of both genders were included in the study by convenience sampling. Patients who had closed Gartland Type II and III fractures and reported within 24 hours of injury were included in the study. Standardized percutaneous cross. K wiring (medial and lateral) was performed in all the patients, followed by casting, by an orthoropedic surgeon. K wires were removed after four weeks. Patients were followed for upto 06 months and all the early and late post-operative complications were recorded on the given proforma. Evaluation of the results was done on the basis of Flynn’s criteria by measuring loss of elbow motion and carrying angle.
Results: A total of 30 patients completed the study. The mean age was 6.1 years with a gender distribution of 23 males and 7 females. The involved elbow was right in 17(56.6%) patients and 13(43.3%) patients had left sided injury. There were 18(60%) Gartland type II fractures and 12(40%) Gartland III fractures. All of the fractures were extension type. Three patients (10%) had pin tract infections, whereas none had osteomyelitis, neurovascular damage or compartment syndrome. Twenty four patients (80%) had excellent results according to Flynn’s criteria whereas four patients (13.3%) had poor results.
Conclusion: Closed reduction under image intensifier and percutaneous K wiring through medial and lateral approach in selected Gartland Type II and III fractures in children is a safe procedure and provides adequate stabilization with satisfactory results.