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Delayed Open Reduction and K-Wire Fixation of Widely Displaced Supracondylar Fractures of Humerus in Children using
Sanjib Waikhom1, Sagnik Mukherjee2, Irom Ibomcha3
1Associate Professor, Department of Orthopaedics, Regional Institute of Medical Sciences , Imphal, Manipur, India .
Insights
Open reduction and K-wire fixation is a reliable treatment for pediatric humerus fractures with delayed presentation. This method yields satisfactory outcomes even when surgery occurs more than two days post-injury.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Traumatology
Background:
- Supracondylar humerus fractures in children often require emergency percutaneous pinning.
- Delayed treatment due to swelling makes percutaneous pinning challenging.
- Late presentation is a significant issue in developing countries.
Purpose of the Study:
- To evaluate the effectiveness of open reduction and K-wire internal fixation for widely displaced supracondylar humerus fractures presenting after a 2-day delay.
Main Methods:
- Fifty-two children (3-12 years) with Gartland type-III supracondylar humerus fractures, presenting >2 days post-injury, underwent open reduction via a medial approach.
- Fixation was achieved using cross K-wires.
- Outcomes were assessed using Flynn's criteria.
Main Results:
- All 40 patients who completed follow-up achieved satisfactory results per Flynn's criteria.
- The mean age was 4.8 years, with a mean presentation delay of 7.5 days (range 2-14 days).
- Two patients experienced pin site infections.
Conclusions:
- Open reduction with medial approach and cross K-wire fixation is a dependable treatment for pediatric supracondylar humerus fractures with delayed surgical intervention.
Introduction:
Supracondylar fractures of humerus in children are usually treated with percutaneous pinning on emergency basis. When the operating time is delayed, percutaneous pinning is difficult due to massive swelling. Late presentation is common in developing countries.
Aim:
To assess the outcome of open reduction and internal fixation with K-wire of widely displaced supracondylar fracture when operated later than 2 days after the injury.
Materials And Methods:
A total of 52 children (aged 3-12 years) with widely displaced supracondylar fracture of humerus (Gartland type-III) who presented later than 2 days after injury were treated with open reduction through medial approach and fixation with cross K-wires. RESULTs were assessed with Flynn's criteria.
Result:
A total of 40 patients completed follow-up. Mean age of all (n=52) patients was 4.8 years (range 3-12 years). Mean delay of presentation was 7.5 days (range 2-14 days). Hundred percent patients had satisfactory results according to Flynn's criteria. Two patients had pin infections.
Conclusion:
Open reduction through medial approach and fixation with two cross K-wires is a reliable method of treatment for supracondylar fractures of humerus in children when the operation is delayed.
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