Auditing the use of percutaneous pinning as a technique of fixation of unstable humeral supracondylar fractures in Sudanese children

ABSTRACT

Supracondylar fractures of the humerus in children are commonly treated with closed reduction and percutaneous pin fixation. There has been controversy regarding the optimal pin configuration in the management of supracondylar humeral fractures in children. The objectives of this work are to evaluate the effectiveness closed percutaneous pinning [P.C.P.] as a treatment modality of supracondylar fractures of humerus in Sudanese children; To overall improve the strategy of treatment technique local experience in treating displaced supracondylar fracture of the humerus in children and; to assess the results of treatment by closed reduction and percutaneous pin fixation of humeral supracondylar fractures in children. Hospital based prospective analytical observational study conducted in Khartoum teaching hospital during the period from July 2006 to March 2007. Included all children less than 14 years of age, with closed type III supracondylar humeral fracture, extension variant, who treated by closed reduction and percutaneous cross pinning. The results show that 34 patients were available for the final assessments at nineth weeks. Their age ranged between 4-12 years, with mean +/- SD of 7.68 +/- 2.34 years. Twenty-four [70.6%] fractures were fixed with crossed pins whereas ten [29.4%] fractures with two lateral pins. The two lateral pins fixation was found to be significantly associated with loss of reduction [p=0.004]. It was concluded that PCP is safe and effective with good functional outcome in treatment of unstable supracondylar fractures. The best wires configuration is that give ability to extend elbow with much stability