Comparison of two approaches for the treatment of supracondylar fractures in children by K-wires / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical effect between two approaches for the treatment of supracondylar fractures of humerus by K-wires in children.</p><p><b>METHODS</b>From Jan. 2004 to Dec. 2006,117 children with supracondylar fractures of humerus were divided into two groups according to different methods of the K-wires fixation involving two K-wires group and three K-wires group. In two K-wires groups,there were 45 children including 31 boys and 14 girls with an average age of 5.6 years ranging from 1 to 11 years; according to Garland classification, 19 cases were type II, 26 cases were type III. In three K-wires groups, there were 72 children including 47 boys and 25 girls with an average age of 6.8 years ranging from 2 to 12 years; according to Garland classification, 22 cases were type II, 50 cases were type II. The movement and carrying angle of elbow joint were measured for all these patients. According to Flynn criteria for supracondylar fracture the results of two approaches with K-wires were compared.</p><p><b>RESULTS</b>All patients were followed-up from 2 to 24 months (means 15.4 months). In two K-wires group, the results of Flynn were excellent in 27 cases, good in 12 cases, fair in 4 cases and poor in 2 cases, 41 cases gained bony healing, however, fail of fixation arosed in 4 cases and cubitus varus arosed in 2 cases. In three K-wires group, the results of Flynn were excellent in 60 cases, good in 11 cases and poor in 1 case, all cases of three K-wires group achieved bony healing after 6 weeks of operation, the function of joints recovered through exercise and cubitus varus arosed in one case after operation.</p><p><b>CONCLUSION</b>The technique of fixation with K-wires is a stable and reliable methods for unstable supracondylar fracture but medial-lateral three-pin fixation is better than one with two pins.</p>

Prevention of ulnar nerve injury during fixation of supracondylar fractures in children by a medial-lateral three-pin fixation technique / 中国骨伤

<p><b>OBJECTIVE</b>To expore the prevention of ulnar nerve injury during fixation of supracondylar fracture in children by a medial-lateral three-pin fixation technique.</p><p><b>METHODS</b>Eighty-one patients including 54 boys and 27 girls with average age of 6 years old (2.5 to 11 years)were treated by a three-pin fixation technique with insertion of two Kirscher wires from the lateral side and the third wire through the medial side. They were followed-up without any complications related to the ulnar nerve. According to Garland system, there were 25 cases of type II supracondylar fracture and 56 of type III. All patients were treated by a medial-lateral three-pin fixation technique, and external fixation with plaster for 3 weeks.</p><p><b>RESULTS</b>All cases achieved immediate stability and long-term bony fusion postoperatively and no iatrogenic ulnar nerve injury happen.</p><p><b>CONCLUSION</b>The technique is a stable and reliable methods for unstable supracondylar fracture and the iatrogenic injury ulnar nerve can be avoided completely.</p>