Trans-olecranon fossa four-cortex purchase lateral pinning in displaced supracondylar fracture of the humerus – a prospective analysis in 48 children

Abstract

ObjectiveThe current study aims at a functional analysis of trans-olecranon lateral pinning for displaced supracondylar fracture of the humerus (SCFH) in children.MethodsA prospective study of 48 children (30 males, 18 females; mean age: 7.4 years) with displaced SCFH was treated at this institution with modified technique from March 2011 to September 2014. Cases were selected on the basis of inclusion criteria. The functional outcome was assessed clinically by modified Flynn's criteria along with achievement of full range of motion.ResultsAll 48 children with a mean follow up of 20 months (range: 6–26 months) were assessed. All fractures united well. With modified Flynn's criteria, results were excellent in 40 children (83.3%), good in six children (12.5%), and fair in two children (4.2%). There were no poor results. Preoperative nerve palsies seen in four children recovered at ten weeks. Full range of motion was achieved on an average of 20 days after K-wire removal and no new post-operative nerve palsies were noted.ConclusionThe modified trans-olecranon fossa four-cortex purchase (TOF-FCP) technique was promising in all cases of unstable SCFH without the complications of loss of reduction or iatrogenic ulnar nerve injury. This technique is simple, safe, and reproducible, with good clinical results in this type of fracture.

A study on outcome of various K-wire fixations in paediatric supracondylar humerus fractures

“…A comparison of the functional outcome of the TOF-FCP method fixation in our study with that carried out by Kasirajan et al in 2017 showed similar functional outcome. 2 In our clinical study, out of 17 cases 100% showed excellent and good results which is similar to study by Kasirajan which had 96% satisfactory outcome. For cosmetic outcome the mean carrying angle in our study with its standard deviations was well within the range of the same obtained in other similar studies (Table 6).…”

“…Recently 'trans-olecranon fossa-four cortex purchase (TOF-FCP)' pin fixation technique has reports of having better torsional stability than conventional LOP and retaining its fewer complications. 2 But it affects mobility at elbow with early stiffness. Therefore, we conducted this prospective study to compare the outcome of all the three constructs for cosmetic and functional outcomes and complications comparison.…”