A comparative study of clinical outcome of surgical management of supracondylar fracture of humerus in children with crossed (Medial and Lateral) k-wire fixation and two lateral k-wire fixation

Abstract

Supracondylar fractures of Humerus comprise about 17 percent of all childhood fractures. Treatment of supracondylar fractures has included closed reduction and casting in hyper-flexion, traction, open reduction with pinning and closed reduction with pinning. The goal of all forms of treatment is the same, to obtain and maintain an anatomic reduction of the distal humerus to minimize complications such as nerve injury, compartment syndrome. Volkmann ischaemic contracture, Cubitus varus deformity and limitation of elbow movements. The nonoperative management of supracondylar fracture of humerus including skin traction, skeletal traction and cast application has historically been associated with a greater incidence of failure to obtain and maintain the fracture reduction and subsequent complications as compared with surgical line of treatment. The high rate of complications associated with non-operative treatment led to the evolution of current techniques of percutaneous pinning for these difficult fractures over the past three decades. Standardization of surgical techniques for performing pin fixation with radiographic control has markedly reduced the incidence of poor outcomes. The advantages of percutaneous pinning methods include easier management of extensively swollen elbows, better maintenance of reduction and decreased risk of associated complications. 2 The present study is an attempt towards assessing and comparing the results of two methods of pinning-crossed pinning and lateral pinning -presently followed in the management of these difficult fractures.

A Comparative Study to Determine the Outcome of Supracondylar Fracture of Humerus in Children Treated with Percutaneous Cross Pinning Versus Two Lateral Pinning

“…In children, it accounts for 3% in all sort of fractures [1][2] . Although the frequency of getting supra-condylar fractures gets rare as the kids proceeds towards the adolescent age [3][4] . The mean age group which is affected by this fracture is 7½ years.…”