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Comparative Study of Stabilization of Humerus Supracondylar Fracture in Children by Percutaneous Pinning From Lateral
M K Roy1, M T Alam, M W Rahman
1Dr Malay Kumar Roy, Junior Consultant (Ortho-Surgery), Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh;
Insights
This study evaluated surgical outcomes for pediatric humerus fractures using percutaneous Kirschner-wire fixation. Both lateral and crossed Kirschner-wire techniques demonstrated comparable, favorable functional results in children with supracondylar humerus fractures.
Area of Science:
- Orthopedic Surgery
- Pediatric Traumatology
- Radiology
Background:
- Supracondylar humerus fractures are common in children.
- Optimal surgical management aims for excellent functional outcomes and minimal complications.
Purpose of the Study:
- To compare radiological and clinical outcomes of closed reduction and percutaneous Kirschner-wire fixation for pediatric supracondylar humerus fractures.
- To evaluate functional outcomes using Flynn's grading for two fixation techniques: lateral versus crossed Kirschner wires.
Main Methods:
- A prospective experimental study included 30 pediatric patients (ages 2-12) with closed supracondylar humerus fractures.
- Patients were divided into two groups: Group I (lateral Kirschner-wire fixation) and Group II (crossed Kirschner-wire fixation).
- Radiological and clinical assessments, including range of motion and carrying angle, were performed post-operatively, with functional outcomes graded using Flynn's criteria.
Main Results:
- No significant difference (p>0.05) was observed in the loss of elbow range of motion or carrying angle between the two groups.
- Functional outcomes were predominantly good to excellent in both groups: Group I (20% excellent, 66.67% good, 13.33% fair) and Group II (20% excellent, 60% good, 20% fair).
- Post-operative hospital stays were minimal (1-2 days) in both groups.
Conclusions:
- Percutaneous Kirschner-wire fixation, whether applied laterally or in a crossed technique, is an effective treatment for pediatric supracondylar humerus fractures.
- Both methods yield comparable and satisfactory functional outcomes with minimal complications.
- The choice between lateral and crossed Kirschner-wire fixation can be based on surgeon preference and fracture pattern.
Abstract:
The aim of this prospective experimental study was to analyze the radiological and clinical results of the supra condylar fracture of Humerus in children and conducted the functional outcome of closed reduction and internal fixation by percutaneous Kirschner-wire from lateral side and crossed technique in the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Sher-E-Bangla Nagor, Dhaka, Bangladesh from July 2011 to June 2013. Patients diagnosed as closed Supracondylar fracture of Humerus in children due to trauma were the study population. Total 30 patients aged 2 to 12 years irrespective of sex were included in the study and were divided in 2 groups. Information obtained included age, sex, type of fracture, management, outcomes and complications. The mean age was 7.80±2.08 and 5.93±2.31 years for Group I and Group II patients. Age range was 2-12 years. Males were predominant 11(73.3%) Group I and Group II. Fractures were primarily caused by fall from tree and left side predominant. In Group I the time elapsed between injury and surgery was minimum 2 hours and maximum 24 hours with mean±SD was 9.20±7.20, while in Group II minimum and maximum of 3 and 48 hours respectively with mean±SD was 9.60±11.01. Minimum and maximum post operative hospital stays were 1 and 2 days in Group I and Group II. Follow-up were carried out after 1, 3, 6 and 12 weeks of operation. Loss of post operative range of motion of elbow and loss of carrying angle was not significant (p>0.05). Functional outcome was analyzed by Flynn's grading. In this study there were 3(20%) cases with excellent, 10(66.67%) were good and 2(13.33%) were fair functional outcomes in Group I. In Group II excellent, good and fair functional outcome were 3(20%), 9(60%) and 3(20%) respectively. After chi-square test there was no significant difference between two groups.
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