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Management of Pediatric Supracondylar Humerus Fractures Using Lateral Cross-Wiring Technique Under Fluoroscopic
Man D Phan1, Nam Q Vo2, Tuong T Mai3
1Orthopaedic Surgery, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, VNM.
Insights
Lateral cross-wiring effectively treats pediatric supracondylar humeral fractures, restoring function and appearance while preventing nerve injury. This technique offers a safe and beneficial option for managing these common childhood elbow fractures.
Area of Science:
- Pediatric Orthopedics
- Surgical Techniques
- Traumatology
Background:
- Supracondylar humeral fractures are common elbow injuries in children.
- Current treatments often involve Kirschner wire fixation.
- The lateral cross-wiring technique shows promise for improved outcomes.
Purpose of the Study:
- To evaluate the efficacy of lateral cross-wiring for pediatric supracondylar humeral fractures.
- To assess functional and cosmetic results.
- To determine the technique's impact on ulnar nerve injury rates.
Main Methods:
- Prospective study of 48 pediatric patients with Gartland type III fractures.
- Treatment involved lateral cross-wiring fixation.
- Minimum follow-up of eight months.
Main Results:
- All patients achieved satisfactory restoration of the carrying angle and function.
- No iatrogenic radial or ulnar nerve injuries were reported.
- Positive functional and cosmetic outcomes were observed.
Conclusions:
- Lateral cross-wiring is an effective treatment for pediatric supracondylar humeral fractures.
- The technique promotes good functional and cosmetic recovery.
- It significantly reduces the risk of iatrogenic nerve injury.
Background:
Supracondylar humeral fractures are the most prevalent elbow fractures in pediatric patients. Current treatment modalities typically involve closed reduction and fixation using percutaneous Kirschner wires. The lateral cross-wiring technique has demonstrated favorable functional and cosmetic outcomes, thereby reducing the incidence of ulnar nerve injury.
Objectives:
This study aimed to assess the efficacy of the lateral cross-wiring technique in achieving optimal functional and cosmetic recovery while mitigating the risk of ulnar nerve injury in pediatric patients with displaced supracondylar humeral fractures.
Materials And Methods:
A prospective analysis was conducted on 48 patients who underwent lateral cross-wiring for displaced supracondylar fractures (Gartland type III, including extension and flexion types) of the humerus. Follow-up assessments were performed over a minimum period of eight months post-surgery.
Results:
Among the 48 patients, all demonstrated satisfactory restoration of the carrying angle and functional ability postoperatively. Notably, no iatrogenic cases of radial or ulnar nerve injury were observed during the follow-up period.
Conclusion:
The lateral cross-wiring technique emerges as an effective treatment option for displaced supracondylar fractures of the humerus in pediatric patients. It facilitates both functional and cosmetic recovery while concurrently reducing the risk of ulnar nerve injury, thus warranting consideration in the management of such fractures.
