Analysis of displaced supracondylar fractures in children treated with closed reduction and percutaneous pinning

Sakthivel, Rajarajan Nagu; Balakrishnan, Vijayan; Vadivelu, Ganesh

doi:10.18203/2320-6012.ijrms20161232

Cited by 3 publications

(5 citation statements)

References 12 publications

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“…Our study findings are in comparison with other studies which reported excellent to good results from 74.02 % to 94%. 11,15,35 The results of our study are comparable with other study results reported in the literature. Closed reduction with pinning aids in early discharge of patient.…”

Section: Discussionsupporting

confidence: 91%

“…Other studies in the past have shown variable percentages of loss in carrying angle ranging from 82.9% to 91.75%. 19,20,35 Our study showed that, about 85.72 % fractures had Baumann's angle in the normal range at the final follow up as compared to other study which reported normal Baumann's angle in 66% of the fractures. 36 Functional results based on Flynn's grading system showed that 94.28% (n=35) children had satisfactory results.…”

Section: Discussionsupporting

confidence: 41%

“…[30][31][32][33][34] Pin tract infection rate ranges from no pin tract infection to 5.8% in the previous studies. 11,20,35 In this study 1 patient (2.85%, n=35) had a pin tract infection that responded to the oral antibiotics. Studies have shown the loss of elbow range of movements between zero to five degrees, which was 4.49 degrees in this study.…”

Section: Discussionmentioning

confidence: 64%

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Assessment of functional and radiological outcomes of closed reduction and K-wire fixation of supracondylar fracture of humerus in children

Ranganath¹,

Choudhary²,

Mayi³

2023

PJMS

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: Supracondylar fractures of the humerus are commonly seen in children and are difficult to manage because of their unstable nature. It is difficult to maintain the reduction with splints. Non-operative treatment is associated with malunion and open reduction is more invasive procedure. Closed reduction of the fracture with percutaneous K-wire fixation is the preferred procedure with satisfactory results. : Children who came to the tertiary care hospital with a fracture in the supracondylar region following history of trauma to the elbow region and X-ray showing Gartland Type II and extension Type III fractures were included in this study. All these fractures were managed with closed reduction and fixation with K-wires inserted by percutaneous technique. Functional outcome and radiological union were noted.: A total of 35 children were operated. About half of the study population were in the range of 6 to 8 years. Majority of study subjects were boys. The average time period between sustaining a fracture and surgical procedure was 1.35 ± 0.48 days. The final results of this treatment modality were graded based on Flynn’s criteria and about 94.28% of study subjects had excellent to good outcomes. One child had complication of superficial pin tract infection.: Displaced supracondylar fractures of humerus can be effectively managed with closed reduction and percutaneous criss-cross K-wire fixation. This procedure does not disturb the normal fracture healing process.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 41%

Section: Discussionmentioning

confidence: 64%

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Assessment of functional and radiological outcomes of closed reduction and K-wire fixation of supracondylar fracture of humerus in children

Ranganath¹,

Choudhary²,

Mayi³

2023

PJMS

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“…We studied 20 patients with mean age of 7.75 years with majority of the patients being males. This sort of age/sex distribution was comparable to other similar studies [15,16] the increased male preponderance could be explained by the usual habit of boys that they do more sports activities outside home, which make them susceptible for sustaining fractures [17] . Non dominant extremity was involved in 70% of the cases.…”

Section: Discussionsupporting

confidence: 89%

Outcome of delayed surgery in gartland type III supracondylar fractures of humerus in children

Khan¹,

Sehgal²,

Shahi³

et al. 2020

Nat. J. Clin. Orthop.

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Background: Supracondylar fracture of humerus in children constitutes more than half of paediatric elbow injuries requiring hospitalisation. Data over outcomes of delayed surgery in Gartland type III fracture supracondylar humerus in children is scarce and no clear guildelines exist regarding management of such injuries. Hence, we envisaged to study the functional and radiological outcome and complications of delayed surgery (between 2-12 days) in paediatric patients with Gartland type III supracondylar fracture of humerus. Material and Methods: A prospective interventional study was conducted in 20 patients aged 4-12 years presenting in Orthopaedic OPD / emergency with Gartland type III fracture supracondylar humerus without associated neurovascular compromise and without other injuries who underwent delayed open reduction and cross K wire fixation through medio-lateral approach. At latest follow up (min 3 months), functional outcome was assessed using Flynn's criteria which includes loss in range of motion (ROM) and loss of carrying angle. Radiological outcomes were assessed using Baumann's angle and anterior humeral line. Complications, if any will be noted. Results: Mean age was 7.75 ± 2.38 years (4-12 years) and mean delay in surgery was of 3.9 ± 1.65 days (2-9 days). Out of 20 patients, right sided extremity was involved in six (20%) patients while 14 (70%) patients suffered injury over left side. The minimum follow up period was of three months with a mean follow up of 5.54 ± 0.72 months. The mean loss in ROM was 21.2⁰ ± 13.5⁰ (5⁰-55⁰) at three on this and 12.4⁰ ± 8.8⁰ (0⁰-30⁰) at six months. The difference was found to be statistically significant (p-value˂0.05). The mean loss of carrying angle was 8.1⁰ ± 6.21⁰ (1⁰-22⁰) at three months and was 4.58⁰ ± 5.65⁰ (0⁰-20⁰) at six months of follow up which was found to be statistically significant (p-value˂0.005). As per Flynn's criteria, functional outcome was found to be satisfactory in seven (35%) patients and unsatisfactory in 13 (65%) patients at three months follow up. Twelve patients reached six months follow up period, seven (58.3%) patients had satisfactory outcome while five (41.7%) patients had unsatisfactory outcome. Difference in Baumann's angle was found to be statistically insignificant when compared with immediate postop and latest follow up (min three months). During immediate postop anterior humeral line passed through capitellum in 90% patients and anterior to capitellum in 10% cases. At latest follow up, it passed through capitellum in 85% cases and anterior to capitellum in 15% cases. Postop serous blisters and pin site infection each was found in one (5%) patient while cubitus varus was found in four (20%) patients. Conclusion: At three months follow up, we achieved satisfactory results in some patients but with continued physiotherapy we were able to achieve satisfactory results in significant proportion of patients at six months follow up. So open reduction with K wire fixation is a reasonably fair method for tackling delayed presenting Ga...

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“…In a study "Analysis of displaced supracondylar fractures in children treated with closed reduction and percutaneous pinning" by Sakthivel RN et al, 74.3% showed Satisfactory and 11.4% showed unsatisfactory functional outcome as per Flynn criteria. (19) Ali Reisoglu et al in his study "Is pin configuration the only factor causing loss of reduction in the management of pediatric type III supracondylar fractures? ", found13.7% loss of reduction in their study result, which was well correlated with the related literature (20) .…”

Section: Discussionmentioning

confidence: 99%

A Prospective Analysis of Functional Outcome In Pediatric Supracondylar Humerus Fracture

Sheth¹,

Reddy²,

Pawar³

et al. 2020

IJOTSS

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Context: Supracondylar humerus fractures are one of the commonest upper limb fractures in children. Closed reduction and fixation with K wires is the most common method of treating these fractures. Stability of fixation is very important so as to prevent loss of reduction, which leads to deformity at elbow joint. Many factors contribute to the stability of fixation. Thus, considering all these factors at the fixation helps prevent loss of reduction. Aim: This prospective study was aimed at studying the functional outcome of management of supracondylar humerus fracture in the pediatric population when the management is planned as per the fracture patterns described by Bahk. Design: This is a single center prospective study conducted between July 2018 and June 2019.This study was done in a medical college and general hospital, which is a tertiary care center. Method: 100 cases of supracondylar humerus fractures in children were analyzed prospectively. Various parameters were documented to assess the functional outcome. Results: There was mean loss of motion at the elbow of 41°in conservatively managed cases and 43°in operated cases at 4th week follow up. Gradually it improved to full range.Loss of carrying angle was seen in only 8% of cases and the degree was very less. As per Flynn's criteria, 94% of cases had excellent cosmetic outcome and 6% of cases had good cosmetic outcome. Anterior humeral line passed through middle one third of capitellum in 91% of cases. Loss of Baumann's angle was seen in only 9% of cases. As per Skaggs et al criteria for loss of reduction, only 1 case had a moderate loss of reduction and 8 cases had mild displacement. Conclusion: Deciding about pin configuration for fixation should be done as per the fracture pattern and fracture comminution.

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Analysis of displaced supracondylar fractures in children treated with closed reduction and percutaneous pinning

Cited by 3 publications

References 12 publications

Assessment of functional and radiological outcomes of closed reduction and K-wire fixation of supracondylar fracture of humerus in children

Assessment of functional and radiological outcomes of closed reduction and K-wire fixation of supracondylar fracture of humerus in children

Outcome of delayed surgery in gartland type III supracondylar fractures of humerus in children

A Prospective Analysis of Functional Outcome In Pediatric Supracondylar Humerus Fracture

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