Comparison of the two methods of percutaneous K - wire fixation in displaced supracondylar fracture of humerus in children

ABSTRACT

To compare the effectiveness and safety of fractures treated by percutaneous medial-lateral cross K-wire fixation and 2-lateral K-wire fixation. Randomized controlled trial was conducted from January 2008 to July 2009 in Orthopedics unit of Hayatabad Medical Complex Peshawar. A total of 50 patients of displaced supracondylar fracture of humerus presenting between age 1-12 years were randomly allocated in two groups of 25 patients in each group and were subjected to medial lateral cross K wire fixation and 2 lateral K wire fixation. Mean age of patients was 7.02 +/- 2.25 years.72% of patients with carrying-angle loss was excellent results and 28% good results. The mean loss of elbow flexion and loss of elbow extension were 8.38° +/- 3.10 and 7.26° +/- 3.22 respectively. In Patients with med-lat cross K-wire fixation group 72% were excellent results and 28% good results, while similar results were found in 2-lateral K- wire fixation group. The 4% iatrogenic ulnar nerve injuries occurred with the med-lat cross K-wire fixation group, while no neurological injury occurred with 2 lateral K wire fixation with p value of 0.312. Hence, there was no significant difference in the incidence of ulnar nerve injury between the two groups of patients. Both techniques appear to be effective, 2 lateral K-wire fixation is as effective in term of stability as medial-lateral cross K- wire fixation but with less chance of iatrogenic ulnar nerve injury