STUDY OF RESULTS OF CLOSED REDUCTION AND PERCUTANEOUS PINNING IN SUPRACONDYLAR FRACTURES OF HUMERUS IN CHILDREN

Dr. Shailesh D. Ramavat; Dr. Manthan Soni; Dr. Dixit Savajiyani

Volume : VI, Issue : V, May - 2016

STUDY OF RESULTS OF CLOSED REDUCTION AND PERCUTANEOUS PINNING IN SUPRACONDYLAR FRACTURES OF HUMERUS IN CHILDREN

Dr. Shailesh D. Ramavat, Dr. Manthan Soni, Dr. Dixit Savajiyani

Abstract :

Supracondylar fractures are important due to its various vascular and neurological complications and late sequelae like volkmans ischemic contracture, cubitus varus and myositis ossificans. So it is mandatory to have proper reduction and maintenance of reduction to achieve reasonable long term results and avoid above mentioned complications. There are different modalities of treatment like cross pinning and two lateral pinning. The aim of this study was to assess the efficacy of treatment of this fracture using cross pinning or two lateral pins. Our study has analyzed the results and complications of supracondylar fractures. Background: Supracondylar fractures are important due to its various vascular and neurological complications and late sequelae like volkmans ischemic contracture, cubitus varus and myositis ossificans. So it is mandatory to have proper reduction and maintenance of reduction to achieve reasonable long term results and avoid above mentioned complications. There are different modalities of treatment like cross pinning and two lateral pinning. The aim of this study was to assess the efficacy of treatment of this fracture using cross pinning or two lateral pins. Our study has analyzed the results and complications of supracondylar fractures. Materials and Methods: 50 cases of displaced supracondylar humerus fractures were included in the study. The mean age of the patients was 6.7 years (range 3–12 years). The male/female ratio was 5:1 and left side was involved in 70% whereas 30% had right sided injuries. The most common mode of trauma was fall from height with elbow in extension. All the 50 consecutively admitted patients had extension type injury with 73.3% fractures being Gartland type III and 26.7% were type II. Posteromedial displacement was noted in 70% whereas 30% fractures were posterolaterally displaced. In 30 cases, two lateral entry pinning technique whereas, in 20 cases, cross K–wire technique was used. K–wires were removed 3 weeks postoperatively and follow up was done at 6 weeks and 12 weeks when they were evaluated according to the criteria described by Flynn. Chi–square test was used as a statistical test of significance to compare results among different variables. Results: Results were graded according to Flynn‘s criteria. Excellent results were achieved in 7 (13.3%), good in 30(60%), fair 8 (16.7%) while in five patients (10%) poor results were obtained. Conclusions: Both lateral entry K–wires and cross k wire fixation techniques provide stable fixation and results are equivalent in both groups except ulnar nerve involvement in cross pinning.