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A Prospective Analysis of Functional Outcome of Pediatric Supracondylar Humerus Fracture Treated with Closed
Saravanan Alagesan1, Sheik Mohideen1, E Pradeep1
1Department of Orthopaedics and Traumatology, Chettinad Hospital and Research Institute, Kelambakkam, Tamil Nadu, India.
Insights
Closed reduction with percutaneous K-wire fixation is effective for pediatric supracondylar humerus fractures. This minimally invasive technique offers good to excellent functional and radiological outcomes with low morbidity.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Traumatology
Background:
- Supracondylar humerus fractures are common pediatric elbow injuries, often leading to complications like cubitus varus deformity.
- Closed reduction with percutaneous K-wire fixation is a preferred treatment method.
Purpose of the Study:
- To evaluate the functional and radiological outcomes of pediatric displaced supracondylar humerus fractures treated with closed reduction and percutaneous K-wire fixation.
Main Methods:
- A study of 35 consecutive pediatric patients with displaced supracondylar humerus fractures.
- Data collected and statistically analyzed using Microsoft Excel.
Main Results:
- Excellent outcomes (Flynn's criteria) were observed in 31 cases, with good outcomes in 3 and fair in 1.
- High Mayo elbow scores (96.01 ± 2.80) at 6 months, with low complication rates including pin tract infections (10 patients) and cubitus rectus (3 patients).
Conclusions:
- Percutaneous pinning following closed reduction is a safe, economical, and effective treatment for pediatric supracondylar humerus fractures.
- Both crossed and lateral pinning configurations yield successful outcomes with minimal invasiveness and low morbidity.
Introduction:
Supracondylar humerus fractures are the most common elbow injuries in children, accounting for approximately 60% of all pediatric elbow fractures, primarily occurring in the first decade of life. These fractures are often associated with complications such as compartment syndrome, neurovascular injury, Volkmann's ischemic contracture, and malunion. The most common complication is cubitus varus deformity. The preferred pinning techniques include either a crossed pin construct or two lateral pins. Among various treatment approaches, closed reduction with percutaneous K-wire fixation has been found to be the most effective, with minimal complications. This study aims to assess the functional and radiological outcomes of pediatric displaced supracondylar humerus fractures managed with closed reduction and percutaneous K-wire fixation.
Materials And Methods:
35 consecutive patients meeting the study's inclusion and exclusion criteria were enrolled. Data are collected and analyzed using Microsoft Excel for statistical calculations.
Results:
In this study, 25 children (62%) sustained the fracture within the first decade of life. Males showed a higher incidence than females. The Mayo elbow scores recorded at 6 months was 96.01 ± 2.80. Pin tract infections were observed in 10 patients, while 3 cases presented with cubitus rectus. Clinical outcomes, evaluated using Flynn's criteria, showed fair outcome in 1 case, good outcomes in 3 cases, and excellent outcomes in 31 cases.
Conclusion:
Percutaneous pinning after closed reduction, whether using a crossed configuration or lateral pinning remains the preferred treatment for supracondylar fracture of the humerus in pediatric patients. When performed with the proper technique, both configurations yield successful outcomes. This approach is a safe, economical, and least invasive option with low morbidity.
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