A Study of Supracondylar Fractures of Humerus in Children by Open Reduction and Internal Fixation with Kirschner Wires.

Background: Supracondylar fractures of humerus is the commonest injury, constitutes about 65.4% of all fractures about the elbow in children. Displaced supracondylar fracture of humerus demand great respect and challenging one to treat, since it requires accurate anatomical reduction and internal fixation to prevent complications. So, in this study, we reported the results of open reduction and internal fixation with K-wires in the displaced (Gartland’s type III) supracondylar fracture humerus in children. Material and Methods: Thirty cases of displaced (Gartland’s type III) supracondylar fractures treated by open reduction and internal fixation with K-wires were studied between September 2011 to August 2013 at our institution and followed for an average of 24 months. Results: We came across 36 male patients and 14 female patients. Majority of the cases (38) were due to high energy trauma of road traffic accidents involving relatively younger patients. At the end of 5 months, all except four patients could mobilize independently without any aid. We did not come across complications like fracture of femur and failure of fixation and no reoperations were required. Conclusions: Open reduction and internal fixation with K-wires is the most commonly accepted treatment of displaced supracondylar fracture humerus in children when done at appropriate time. It gives more stable fixation, better anatomical reduction with negligible complication.

A Different Method of Pinning of Displaced Extension type Supracondylar Fracture of Humerus in Children

A new /different method of pinning of the displaced extension type supracondylar fractures of the humerus in children is presented. Here two pairs of K wires are used. The fracture is reduced under C- arm image intensifier control and then two K wires are passed through lateral epicondyle and holding the reduction two more wires are passed from the lateral supra-condylar ridge obliquely downwards and inwards across the fracture site into the medial epicondyle. Thirty cases, thus treated, are presented here. Mean follow up for 26 cases was 28 months. Four cases were lost to follow up .At the final follow up ,using Flynn's overall modified classification, the clinical result was considered to be excellent in 19 (73%) patients, good in 5 (19.23%) and poor in 2 (7.69%) patients. The protocol described here resulted in good to excellent results in 24/26 cases (92.30%) thus proving its usefulness in displaced extension type supracondylar fractures in children.