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Functional Outcomes of Treatment of Paediatric Supracondylar Fractures With Open or Closed Reduction and Crossed
Mahak Baid1, Anirban Chatterjee2, Shamik Hait3
1Trauma and Orthopaedics, Aneurin Bevan University Health Board, Newport, GBR.
Insights
Crossed Kirschner wire (K-wire) fixation is an effective treatment for paediatric supracondylar humerus fractures, yielding excellent outcomes. This surgical method demonstrates safety and minimal risk of nerve injury when performed by experienced surgeons.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Traumatology
Background:
- Supracondylar humerus fractures are common pediatric elbow injuries.
- Optimal surgical fixation methods remain under debate.
- Crossed Kirschner wire (K-wire) fixation is a frequently used technique.
Purpose of the Study:
- To evaluate the functional outcomes of pediatric supracondylar humerus fractures treated with crossed K-wire fixation.
- To assess the safety and efficacy of this surgical approach.
Main Methods:
- Retrospective observational study of 31 children (1-14 years) with displaced Gartland types 2 and 3 supracondylar humerus fractures.
- Treatment involved closed or open reduction and crossed K-wire fixation.
- Functional outcomes were assessed using the Mayo Elbow Performance Score (MEPS) at one-year follow-up.
Main Results:
- Excellent functional outcomes (MEPS) were observed in 87.1% of patients at one year.
- Good or fair outcomes were noted in 12.8% of patients.
- No cases of malunion, residual deformity, or iatrogenic nerve injury were reported.
Conclusions:
- Crossed K-wire fixation is an effective and safe treatment for displaced pediatric supracondylar humerus fractures.
- The risk of iatrogenic nerve injury is minimal with experienced surgeons and a mini-open medial approach.
- Further large-scale prospective studies are recommended.
Background:
Supracondylar fractures of the humerus are a common type of elbow injury in children, and there is ongoing debate about the best method of surgical fixation.
Objectives:
The aim of this study was to assess the functional outcome of paediatric supracondylar fractures managed using crossed Kirschner wire (K-wire) fixation.
Methods:
This was a retrospective observational study. Thirty-one children (one to 14 years) with displaced supracondylar humerus fracture (Gartland types 2 and 3) treated with closed or open reduction and crossed K-wire fixation were included. Those with undisplaced fractures, flexion-type supracondylar fractures, open fractures, associated ipsilateral limb fractures, previous ipsilateral elbow injury, or neurovascular injury on presentation were excluded from the study. All patients were followed up for a period of one year, and functional outcome was evaluated using the Mayo Elbow Performance Score (MEPS).
Results:
The mean age of the study population was 6.2 years (range: one to 14 years; SD: 3.6), with the majority of patients (51.6%) in the five- to nine-year age group. All fractures were of the extension type. Twenty-three patients (74.2%) sustained Gartland type III fractures, and eight patients (25.8%) had Gartland type II fractures. At the one-year follow-up, as evaluated by the MEPS, excellent functional outcomes were observed in 27 patients (87.1%), good outcomes in two patients (6.4%), and fair outcomes in two patients (6.4%). No individuals exhibited poor outcomes. Additionally, no cases of iatrogenic nerve injury, malunion, or residual deformity were noted at final follow-up.
Conclusion:
Surgical fixation of supracondylar fractures with cross-pinning is an effective and safe modality for treating displaced paediatric supracondylar humerus fractures. When performed by an experienced surgeon using a mini-open medial approach, the risk of iatrogenic nerve injury is minimal. Large-scale prospective studies are required to further validate these findings.
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