Publication:

Management of supracondylar fracture humerus type 3 in children with percutaneous K-wire vs. open reduction and internal fixation with K-wire

Background Aim of the study is to determine the relation between the reduction technique percutaneous pinning and open reduction and internal fixation with K-wire used in management of supracondylar humerus fractures in paediatric age group and the ultimate elbow status (functional and cosmetic), so that appropriate reduction technique can be adopted for better functional and cosmetic outcome.

Methods Children below 12 years with Gartland’s type III supracondylar fractures managed by closed reduction and percutaneous K-wire fixation and open reduction and K-wire fixation and Flynn’s criteria was used to grade the outcome of surgical fixation. 10 Closed reduction and K-wire fixation and 10 open reduction and K-wire fixation were done.

Results Most of the fractures were sustained when the patient had fallen down on out stretched hand while playing or slip and fall. According to Flynn’s grading, there are 7 excellent, 2 good and 1 fair functional result observed in closed reduction and k wire fixation. There are 4 excellent, 3 good and 3 fair functional results observed in open reduction and k wire fixation with statistically significant p value 0.04.

Conclusions Open reduction through lateral approach and internal fixation wire K wires is safe and effective method of treatment, if indicated, in supracondylar fractures of humerus in children and is associated with a good outcome. A small incision medially in cases where medial epicondyle cannot be defined to visualize the epicondyle and the ulnar nerve, by which iatrogenic ulnar nerve palsy in percutaneous fixation can be prevented.