Stability after close reduction and stabilization by two percutanious pinning technique in type-Ill supracondylar fracture of humerus

ABSTRACT

The objectives of this study were to compare the stability of fixation in Supracondylar fracture humerus in children between two techniques of pin fixation [cross K wires and two parallel wires] at four weeks and to compare Ulnar Nerve injury. Study design was Quasi experimental and done at Orthopaedic Complex, Bahawal Victoria Hospital Bahawalpur. The study period was one and half year. Two groups A and B of thirty patients each formed after convenience non-probability sampling technique. Group A was treated by medial lateral cross K wire fixation after close reduction. Group B was treated by lateral two pins placed parallel to each other. In-group A there was 23 male and 7 female children. In-group B there was 24 male and 6 female children. All treated patients were evaluated clinically on next day for distal neurovascular status especially for ulnar nerve in group A. Reduction checked on plane AP and Lat elbow X-rays. On AP Bauman's angle and on lateral X-ray shaft condyl angle measure and compare with normal side X -rays. After four weeks X-ray again done and compared with the first post-op X-rays. A difference of 5 degree noted as mild stability loss and change of 5-10 degree taken as major stability loss. Three patients treated by lateral k wires and one in patients treated with cross k wires had a mild loss of reduction. No patient in either group had a major loss of reduction. No ulnar nerve injury noted in both groups. Cross k wire fixation method is more stable than lateral paralle wires. Cross K- wire fixation method is also safe with no iatrogenic ulnar ner injury when medial wire pass after lateral wire and extending the elbc beyond the 90 degree with medial incision on epicondyle