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Open Reduction and Internal Fixation of displaced Supracondylar Fractures of Humerus with Crossed K-wires via Medial
S Hussain1, S Dhar1, A Qayoom1
1Department of Physical Medicine & Rehabilitation,Sheri-Kashmir Institute of Medical Sciences, Soura, India.
Insights
The medial approach for open reduction and internal fixation of Gartland type 3 humerus fractures in children is safe and effective. This technique resulted in satisfactory outcomes for 88.09% of patients, with no ulnar nerve injuries.
Area of Science:
- Pediatric Orthopedics
- Traumatology
- Surgical Techniques
Background:
- Gartland type 3 displaced supracondylar fractures of the humerus are common in children.
- The medial approach for surgical fixation is an alternative technique.
- Medial column comminution can complicate fracture management.
Purpose of the Study:
- To evaluate the efficacy and safety of the medial approach for open reduction and internal fixation of Gartland type 3 humerus fractures in children.
- To assess outcomes using Flynn's criteria.
- To analyze complications associated with the medial approach.
Main Methods:
- Prospective, single-center study involving 42 children with displaced supracondylar humerus fractures.
- Open reduction and internal fixation using crossed K-wires via a medial approach.
- Mean follow-up of 12 months, with assessment using Flynn's criteria.
Main Results:
- 88.09% of patients achieved satisfactory results according to Flynn's criteria.
- No cases of post-operative ulnar nerve injury were reported.
- Three patients experienced superficial pin tract infections, which resolved with conservative treatment. No deep infections occurred.
- Cubitus varus deformity was not observed in any patient.
Conclusions:
- The medial approach offers an excellent view of the supracondylar region for fracture fixation.
- This surgical technique is associated with a low risk of ulnar nerve injury.
- The medial approach demonstrates good functional outcomes and acceptable scar healing in pediatric humerus fractures.
Abstract:
This study aimed at evaluating the medial approach for open reduction and internal fixation of Gartland type 3 displaced supracondylar fractures of humerus in children. A prospective, single centre study of on displaced supracondylar humerus fractures in 42 children was carried out at our institute. All fractures were managed with open reduction and internal fixation with crossed K-wires via medial approach. The mean follow-up was 12 months and patients were assessed according to Flynn's criteria. No patients had post-operative ulnar nerve injury. Cubitus varus was not seen in any patient. Superficial pin tract infection occurred in three patients that subsided with anti-septic dressings and antibiotics. No deep infection occurred. 88.09 % patients showed satisfactory results as per Flynn's criteria. The medial approach provides an excellent view of the supracondylar area. The approach is convenient due to a lower risk for ulnar nerve injury and better acceptability of the medial incisional scar.
Key Words:
Type 3 supracondylar fracture humerus, medial approach, crossed K-wire fixation, medial column comminution.
