Functional outcome of displaced supracondylar fracture humerus in children treated by closed reduction and percutaneous pinning with Kirchner wires: An observational study

Abstract

Background: Displaced supracondylar fracture of humerus is a common orthopaedics problem in children. The most common complications associated with these fractures are mal-union leading to cubitus varus, stiffness of elbow, myositis ossificans, compartment syndrome and neurovascular deficit. Different methods have been described for its management of which closed reduction and percutaneous pinning with K-wires has been preferred treatment with satisfactory results. Material and Methods: Between March 2017 to May 2018, 36 patients with supracondylar fracture of humerus of Gartland type II & III in children were included in this study. These patients were treated by closed reduction of fracture and percutaneous fixation with K-wire under C-arm guidance. The functional outcome was assed clinically by Flynn's criteria. The assimilated data was analyzed using various statistical methods like descriptive statistics (mean, standard deviation, standard error), chi-square test. Estimates of population proportions were obtained using estimator sample proportions and 95% confidence intervals under standard normal distribution approximation for large sample. Results: In our study, the mean age of the patients was found to be 6.64 years with male preponderance (72.22%) as compared to females (27.78%). Statistical analysis (test statistic; Fisher Exact test for count datatwo sided) on the observations of Flynn's grading score for different fixation methods viz. 2 Crosswire (2C), 2 Lateral (2L) and 3K-wire depicted that proportions of satisfactory grading in all fixation methods (2C, 2L and 3K) are same (p-value 1.00) and hence results found no significant difference between fixation methods and Flynn's grading score. This study revealed that the mean hospital length of stay for 2C and 3K fixation methods was 2.11± 0.29 and 2.33 ± 0.35 (p-0.609) respectively. The satisfactory result for loss of carrying angle and loss of range of motion was 94.44% and 100% for 2C and 3K fixation methods respectively. Conclusions:The results of our study demonstrated that closed reduction and percutaneous fixation using K-wire of displaced supracondylar fractures of humerus in children would be the simple, cheap, safe and effective method of treatment with relatively fewer complications and reduced hospital stay.

A comparative study of functional outcome of criss-cross pinning vs parallel pinning for Gartland type III supracondylar humeral fractures in children in tertiary care centre

“…In group 2 with parallel all the 100% had excellent score whereas in group 1, 94% had excellent score and 6% had good score. Vikram A, et.al, has also reported similar findings that subjects with parallel pinning had 100% excellent scores [17] . In group 2 with parallel pinning none had associated injuries but in group 1 around 3% had associated nerve injury.…”

Treatment Options for Pin Site Infection during Kirschner Wires in Elective Forefoot Surgery

“…In that surgical study, they majorly dealt with closed removal of fracture and the K-wire based percutaneous fixation under the DOI: 10.4236/ojo.2021.112006 50 Open Journal of Orthopedics C-arm guidance. According to their statistical outcomes, it becomes concluded that percutaneous fixation and closed reduction by using K-wires of humerus' displayed supracondylar fractures would be safe, cheap, simple, and the effective way to reduce the hospital stay by developing such treatment which has relatively fewer complications [12]. In addition to this, other scholars also worked on a related topic by evaluating the outcome of phalangeal fractures based surgery along with K-wires in the Hue Central Hospital.…”

Management of Supracondylar Fractures of the Humerous in Children

“…Compartment syndrome should always be considered, especially if there is skin puckering, significant ecchymosis/swelling, vascular changes, or simultaneous forearm fractures [3,4]. The most prevalent presentation of supracondylar humerus fractures, accounting for 90% of all instances, occurs between the ages of 5-7 years, and the non-dominant arm is more usually implicated [5,6]. While the most common mechanism of injury is a fall onto the outstretched hand with the elbow in full extension, clinical presentation of these fractures is in extension for 97-99% of cases [7,8].…”