<p class="abstract"><strong>Background:</strong> Distal humeral fractures are one of the most common types of fractures in children, most of them being supracondylar. Supracondylar fractures are usually caused by trauma, most likely falls. It is an emergency, requiring rapid diagnosis and management to avoid serious complications. Recommended treatment modalities vary from no reduction and immobilization to open reduction and internal fixation. Kirschner wire (K-wire) fixation of displaced supracondylar fractures after closed reduction is a preferred method and is being performed for over 50 years now. This study was conducted to determine the functional outcome of crossed K-wire fixation in pediatric supracondylar fracture.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted from May-November 2018 at the department of Orthopedics, Abbasi Shaheed Hospital, Karachi, Pakistan. It was inferred that functional outcome of pediatric displaced supracondylar humeral fractures is satisfactory when managed with percutaneous crossed K-wire fixation. It included 83 children with supracondylar fractures. They were treated with percutaneous crossed K-wire fixation. Patients were then followed up to determine satisfactory functional outcome according to Flynn’s criteria. Data entry and analysis was done using SPSS 21.0.</p><p class="abstract"><strong>Results:</strong> Eight-three patients were included. The mean±standard deviation age of this study population was 7.03±3.39 years. Out of the study participants, 47 (56.6%) were males and 36 (43.4%) were females. 71.1% of the patients were of Gartland class II fractures and 28.9% were of Gartland class III. 43.4% had an injury due to fall while playing while 19.3% had fallen from height. 80.7% were found to have a satisfactory functional outcome.</p><p class="abstract"><strong>Conclusions:</strong> It was inferred that the functional outcome of pediatric displaced supracondylar humeral fractures is satisfactory when managed with percutaneous crossed K-wire fixation.</p>
Introduction: Forearm fractures are the most common fractures in children, accounts 30% to 40% of all fractures. Most of these fractures are treated by close reduction and immobilization. Both national (80%) and international (58.8%) literature shows marked variation in the outcome of conservative management of forearm fractures. Operative management becomes popular due to complications of conservative treatment, which includes re-displacement, compartment syndrome, residual deformation and loss of mobility. Materials and Methods:The study was conducted at Department of Orthopedic unit 2 of Abbasi Shaheed Hospital. All children of less than 14 years of age with forearm fractures were included. Data was collected through a self-administered proforma. Closed reduction and POP cast was done under sedative analgesia. Patients were followed up initially after 3 days and a check X-ray was done and re-manipulation was performed if needed. Then patients were followed every week for four weeks and fresh X-ray was done on every visit. Data was analyzed by using IBM SPSS v.20. Results:The study included thirty patients with forearm fractures, males being dominant. The mean age was 7.47 years. Majority of males 16 (76.2%) and females 8 (88.8%) had combined fractures of radius and ulna. The most common cause of injury was fall during play 22 (73.3%). Majority of the children 21 (70%) had fractures of radius shaft. Shaft of ulna was fractured in 18 (60%) children. Satisfactory outcome was achieved in 23 (76.7%) of the participants. Re-displacement was seen in 3 (10%) patients during follow-up. Conclusion:Conservative management for pediatric forearm fractures is a successful treatment with high success and low complication rate. Therefore we recommend conservative management for pediatric forearm fractures.
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