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

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.