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Percutaneous K-wiring for Gartland type III supracondylar humerus fractures in children
Abdul Q Khan1, Siddharth Goel, Mazhar Abbas
1Department of Orthopedic Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India. drabdulqayyum@rediffmail.com
Insights
Closed reduction and percutaneous K-wire fixation effectively treat Gartland type-III supracondylar humerus fractures in children. This method ensures adequate reduction and satisfactory outcomes with minimal complications.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Traumatology
Background:
- Gartland type-III supracondylar humerus fractures are common in children.
- Achieving and maintaining adequate reduction is crucial for optimal outcomes.
- Minimally invasive techniques are preferred to reduce complications.
Purpose of the Study:
- To evaluate the efficacy of closed reduction and percutaneous K-wire fixation for Gartland type-III supracondylar humerus fractures.
- To assess the ability of this technique to achieve and maintain adequate fracture reduction.
- To determine the functional outcomes and complication rates associated with this treatment method.
Main Methods:
- Prospective study of 60 pediatric patients with Gartland type-III supracondylar humerus fractures.
- Treatment involved closed reduction and percutaneous K-wire fixation under image intensifier guidance.
- Fixation was performed using lateral pins, or both lateral and medial pins.
Main Results:
- All fractures achieved union without complications.
- Excellent results were observed in 88.88% of patients, with good results in 4.44%.
- Minor complications included one case of cubitus varus deformity and one of iatrogenic ulnar nerve palsy, which resolved.
Conclusions:
- Percutaneous K-wire fixation is a safe and effective treatment for Gartland type-III supracondylar humerus fractures in children.
- The technique allows for adequate reduction and maintenance of alignment.
- It offers a minimally invasive approach with a low complication rate and short hospital stay.
Objective:
To assess the ability of closed reduction and percutaneous K-wire fixation, to obtain and maintain an adequate reduction, and thereby achieve satisfactory end results.
Methods:
A prospective study conducted on 60 children over 28 months at Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India, from March 2003 to June 2005, in which Gartland type-III supracondylar fracture humerus were treated by closed reduction and percutaneous pinning, either from lateral side only or from medial side also, under image intensifier control.
Results:
There was no problem in union. Patients were graded by Flynn's criteria with excellent results in 88.88%, good in 4.44%, and fair in 2.24%, and poor in 4.44% cases. Only one patient had developed cubitus varus deformity and one had Iatrogenic Ulnar nerve palsy from medial pin, which recovered subsequently. The Baumann's angle was well with in the normal range of 66-84 degrees [corrected]
Conclusion:
Percutaneous K-wire fixation is a safe and effective method for the management of Gartland type-III supracondylar fractures with minimal hospital stay and without risking vascular compromise.
