Supracondylar humeral fracture in children: management by percutaneous lateral-entry pin fixation

ABSTRACT

This case series was conducted at the Department of Orthopaedics and Traumatology, Lady Reading Hospital Peshawar, from January 2007 to June 2008 to assess the outcome of two percutaneous lateral-entry pins in the operative management of supracondylar humeral fractures. The study included management of Type II and III displaced supracondylar humeral fractures according to Wilkins's modification of Gartland's classification system in 193 patients. The fractures were fixed with two percutaneous lateral-entry pins. Seventy-two children had Type II fracture and One Hundred and Sixty-five children presented with Type III fracture according to Wilkins's modification of Gartland's classification system. A comparison of perioperative and final radiographs showed no loss of reduction of any fracture. There was no hyperextension, loss of motion, cubitus varus, iatrogenic nerve palsies and no patient required additional surgery. Six patients had pin tract infection. Follow up rate was 81.5% Results were evaluated by Flynn's Criteria, 93.3% Excellent/good results were obtained. In this case-series, the use of lateral-entry pins was found to give excellent/very good results. It is an effective treatment option for unstable supracondylar fractures of humerus in children. This method provides the greatest skeletal stability and prevents neurovascular complications in children, as in other techniques, hence giving excellent results: