Supracondylar humerus fractures outcome of open reduction and percutaneous crossed pin fixation

Displaced Supracondylar fractures of the humerus in children are common injuries treated by orthopaedic surgeons. To evaluate the role of open reduction and percutaneous crossed pin fixation in displayed supracondylar fractures and to design a simple and effective protocol for the treatment of these fractures. Prospective. Independent Medical College Independent University Hospital Faisalabad. From January 2009 to June 2010. Fifty six cases with grade II and grade III Gartland Supracondylar humeral fractures were treated with open reduction through postereomedial approach and percutaneous crossed pin fixation with Kirschner wire and followed up for a minimum period of 1 year. Patients were assessed on the basis of Flynn's criteria there were 41 Excellent and12 good results It is concluded that open reduction and percutaneous crossed pin fixation is a sound and effective treatment for displayed supracondylar fractures with several advantages but requires careful judgment on the part of surgeon to avoid complications

Open reduction and k-wire fixation of displaced unstable lateral condyle fractures of the humerus in children

Lateral condyle fractures in children are the second most common fracture about the elbow. The problem arises in those cases which are difficult to treat by pop cast or by close reduction with percutaneous pin fixation. Late presentation is another challenge. We selected surgical treatment for such cases up to 12 weeks to evaluate our results. To study the usefulness of open reduction and K-wire fixation of displaced, unstable with or without rotation of fractures lateral condyle of the humerus in children presenting up to 12 weeks post injury Prospective. Three teaching orthopaedic units Independent Medical College / Punjab Medical College, and University Medical College Faisalabad. From January 2008 to December 2010. In this prospective study a series of 22 patients were treated using technique of open reduction and internal fixation with k-wires. The results were assessed by criteria of Agarwal et al with little modification after follow-up for 1 year. Excellent to good results were observed in all the12 patients presenting at 1-4 weeks post injury. In 5 patients presenting at 5-8 weeks, the results were excellent in one, good in 2, fair in1 and poor in one patient. In 5 patients presenting at 9-12 weeks good in 1 fair in 2 and poor in 2 patients. Open reduction and internal fixation is an effective treatment in all cases of displaced fractures of the lateral condyle of the humerus presenting up to 12 weeks post injury on the basis of low surgical complications and high union rate

Outcome of open reduction and intramedullary kirschner-wires fixation for fracture shaft radius ulna in children

Background: There has been a trend toward operative management of pediatric Diaphyseal Forearm Fractures [DFFx]. We studied our experience with surgical management of these injuries to assess outcome and complications

Objective: The purpose of this study was to assess outcome and complications associated with open reduction and intramedullaryKirschner-wire fixation for fracture shaft radius ulna in children

Design: Prospective study

Setting: Orthopedic surgery departments of Independent Medical College, Punjab Medical College and University Medical College Faisalabad

Study Period: Between March 2009 and February 2011

Method: The study group included 32 boys and 12 girls aged 6-15 years with unstable displaced fractures shaft radius, ulna or both. Relevant history and x-rays of the forearm were taken. We followed the inclusion and exclusion criteria. All the cases were treated with open reduction and retrograde Kirchner wire fixation. The cases were followed for at least 6 months. Patients were assessed functionally and radiologically and results were graded according to the system described by Price et al as excellent, good, fair and poor

Results: This prospective study was completed on 44 patients 32 were male and 12 were female. All fractures were united in acceptable alignment. At final assessment there were 30 [68.18%] excellent, 8 [18.18%] good, 3 [06.82%] fair and 3 [06.82%] poor results. The fair or poor clinical outcome was higher in children above 10 years of age. Delayed union after IM intramedullary fixation occurred in 3 children over 10 years of age

Conclusion: This technique can provide precise fracture reduction, maintains stabilization for fracture healing, results in minimal cosmetic deformity, cost effective and facilitates easy removal of implants after treatment

Outcome of augmented external fixation of unstable distal radius fractures

Background: Well-reduced unstable distal radius fractures have the potential to undergo late displacement and/or collapse due to musculotendinous forces. To over come this there is controversy as to which is the preferred treatment - minimally invasive like external fixation or invasive like open reduction and plating

Objective: To determine the outcome of augmented external fixation of unstable distal radius fractures

Design: Prospective study

Setting: Orthopedic surgery department of Independent Medical College, Punjab Medical College and University Medical College Faisalabad

Period: Between January 2009 and December 2010

Methods: In this case series study 46 patients with unstable distal radius fractures were followed for 1 year after operation using the technique of application of common 3.5mm AO external fixator using principle of ligamentotaxis for reduction and restoring length with addition of k-wires plus bone graft if needed. All patients were evaluated according to the sum of demerit points system [Saito, 1983]

Results: There were 20 male [43.48%] and 26 females [56.52%] with mean age 48.54+16.36. According to the sum of demerit points [Saito, 1983], the latest follow-up functional end results were 'Excellent' in 45.66%, Good in 34.78%, Fair in 10.87% and Poor in 08.69%. As for the anatomical results at follow-up, the radial shortening <2mm in 37 [70.44%], from 2- 4mm in 5 patients [10.87%] and >4mm in 4[08.69%]. The average radial tilt was 22°and palmar tilt was 6°

Conclusions: The application of common 3.5mm AO external fixator with addition of k-wires is simple, cost effective, quick, minimally invasive and prevents redisplacement of fracture fragments adequately. The risk of infection is small and there is little damage to the surrounding tissues