Outcome of Close reduction and K Wire Fixation in Patients with Supracondylar humerus fracture presenting late

Dr. Surendra Singh Yadav, Dr.Sameer Gupta, Dr.Prashant Patel, Dr.Vishnu Ravi

Abstract


Background: 36 patients of supracondylar humerus were treated by closed reduction and cross K wire fixation. Fifteen patients had Gartland type II injuries and Twenty-one patients with Gartland type III fracture displacement. There were 28 boys and 08 girls. The average age was 8 years (2–14 years) and the average time of presentation was 30 h (3–96 hour). Patients were followed up on 1st week  and 3rd week and then every 2nd week till fully functional recovery achieved. The mean immobilisation time in the present study was 4.5 weeks (3–5) weeks. The mean follow-up period was 7.4 weeks (5–20). Outcome was assessed using clinically and radiologically. According to Flynn’s criteria used for assessment of result, all patients had satisfactory results. One patient had ulnar nerve palsy after operation. Closed reduction and cross k wire fixation for superacondylar humerus fracture is a safe, closed procedure with satisfactory outcome.

Methods: During the period from 2014 to 2016, 40 cases of supracondylar fracture of the humerus with late presentation were treated at our institute. Inclusion criteria was Gartland type 2 and 3 fractures, duration of injury 5 – 15 days, Exclusion criteria were open fractures, fractures that required open reduction, neurological or vascular injuries found on presentation, previous ipsilateral elbow fracture, presence of any concomitant fractures in the ipsilateral limb and loss to follow-up. We reviewed preoperative clinical examinations, time from injury to surgery, operative notes, postoperative evaluations, duration of immobilisation, time of pin removal, presence of complications, need for further surgery and clinical assessment at final follow-up visit

Results: Sixteen patients with Gartland grade II and twenty four patients with grade III fracture managed with close reduction fixation with K wire were included in the study. The average time of presentation was 7.6 days (range 5 – 15 days). The mean follow-up period was 7.4 (5–20) weeks. Based on Flynn’s criteria, 34 patients (95%) had excellent outcome.

Conclusion: Closed reduction with percutaneous pin fixation is viable option for displaced supracondylar fractures of the humerus with late presentation.

Keywords


pinning, supracondylar humerus late presentation, flynn’s criteria

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References


Gartland JJ. Management of supracondylar fractures of the humerus in children. Surg Gynecol Obstet. 1959 Aug;109(2):145–54.

Gordon JE, Patton CM, Luhmann SJ, Bassett GS, Schoenecker PL. Fracture stability after pinning of displaced supracondylar distal humerus fractures in children. J Pediatr Orthop. 2001 Jun;21(3):313–8.

Madjar-Simic I, Talic-Tanovic A, Hadziahmetovic Z, Sarac-Hadzihalilovic A Radiographic assessment in the treatment of supracondylar humerus fractures in children. Acta Inform Medica. 2012 Sep;20(3):154–9.

Worlock P. Supracondylar fractures of the humerus. Assessment of cubitus varus by the Baumann angle. Bone Jt J. 1986 Nov 1;68–B(5):755–7.

Flynn JC, Matthews JG, Benoit RL. Blind pinning of displaced supracondylar fractures of the humerus in children. Sixteen years’ experience with long-term follow-up. J Bone Joint Surg Am. 1974 Mar;56(2):263–72.

Pirone AM, Graham HK, Krajbich JI. Management of displaced extension-type supracondylar fractures of the humerus in children. J Bone Joint Surg Am. 1988 Jun;70(5):641–50.

Cheng JCY, Lam TP, Shen WY. Closed Reduction and Percutaneous Pinning for Type III Displaced Supracondylar Fractures of the Humerus in Children. J Orthop Trauma. 1995 Dec;9(6):511.

Lyons JP, Ashley E, Hoffer MM. Ulnar Nerve Palsies After Percutaneous Cross-Pinning of Supracondylar Fractures in Children’s Elbows. J Pediatr Orthop. 1998 Feb;18(1):43–45.

Lee SS, Mahar AT, Miesen D, Newton PO. Displaced Pediatric Supracondylar Humerus Fractures: Biomechanical Analysis of Percutaneous Pinning Techniques. J Pediatr Orthop. 2002 Aug;22(4):440–443.

Devnani AS Late presentation of supracondylar fracture of the humerus in children. Clin Orthop Relat Res. 2005 Feb;(431):36-41.

Tiwari A, Kanojia RK, Kapoor SK. Surgical management for late presentation of supracondylar humeral fracture in children. J Orthop Surg (Hong Kong). 2007 Aug;15(2):177-82.

Dahal M, Kumar P, Singh GK, Arora SS, Singh MP. Predicting cubitus varus in supracondylar fractures of the humerus by Baumann’s angles in post reduction X-rays. Kathmandu Univ Med J KUMJ. 2006 Jun;4(2):167–70.


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