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

Abstract

Supracondylar fractures of humerus in children are common injuries. Displaced fractures are
inherently unstable. Conservative treatment results in malunion. Open reduction and internal
fixation (ORIF) is more invasive and recovery is prolonged. From September 2004 to September 2005,
102displacedsupracondylarfractures of humerus, agedbetween one andhalf yearto 13 years, were
treated 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-wires
wereput.Above elbow plaster ofparis back slab was appliedinall cases for atleastfour weeks.Back
slab,K-wireswere removedafterfourweeks andelbowrangeofmotionexercisewas started.Results
were analyzed using Flynn’s criteria. All patients were followed up to 14th week postoperatively. In
cross 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 for
displacedsupracondylarfractures inchildrenas itis safeandcost effectiveprocedurewithacceptable
complication rates.
Key words: closed reduction, humerus, percutaneous pinning, supracondylar fracture