Clinical and Radiological outcome of Gartland Type-III closed supercondylar fracture of humerus in Children treatment by percutaneous K-wires fixation

Abstract

Introduction: Supracondylar fracture of the humerus is the most common fracture of the elbow in children and displacement is common. Main problem regarding management of early supracondylar fracture are obtaining and maintaining reduction as they commonly present in the emergency department with varying degrees of soft tissue swelling. Objective: To assess the Clinical and Radiological Outcome Type III Closed Supracondylar Fracture Of Humerus in Children treatment by percutaneous K-wires fixation. Methods: This study was carried out at the NITOR, over a period of 24 months between January 2015 to December 2016. The total number of patients were 30. All patients suffering from closed supracondylar fracture of humerus in children. Each Gartland type-III closed Supracondylar Fracture of humerus among supracondylar Fracture in children attended at emergency, outpatient department and admitted in NITOR. Results: A total number of 30 patients were enrolled in this study as per inclusion and exclusion criteria. Diagnosis of the supracondylar fracture of humerus was made by history, clinical examination and radiological evidence. The youngest patient in our series is 3 years old and the oldest is 12 years. Majority were in 5-8years. Among 30 patients mean age was 6.85 years with SD = ± 2.37 years. In the present series, maximum patients were male 22 (73.3%) and 8 (26.7%) patients were female. Male female ratio 2.75:1. Male patients were predominant in this study. The results are shown in table-I. In the present series, 19 (63.3%) with left sided supracondylar fracture of humerus and 11(36.7%) presented with right sided supacondylar fracture of humerus. The results are shown in Table-II. Out of 30 cases 15 (50%) cases gave history of fall from tree, 6(20%) cases gave history of fall from bed, 4(13.3%) cases gave history of fall during playing, 5(16.7%) cases gave history of RTA due to fall from bicycle. In the present series, postero-medial fracture was found in 18(60.0%) cases and postero-lateral fracture in 12 (40.0%) cases. Out of 30 patient’s about 16 (53.3%) of the patient’s was operated between (13-18) hours of receiving injury, 11 (36.7%) with in (7-12) hours and 1 (3.3%) within (0-6) hours of injury and 2(6.7%) with in (19-24) hours of injury, mean interval between injury and Operation was 8.06 ± 5.52 hours. Out of 30 patient’s, 22 (73.3%) of the patients stayed in the hospital for 1 day and 8 (26.7%) of the patients stayed in the hospital for 2 days. The mean duration of hospital stay was 1.26 ± 0.45 days. In this series, among 30 Patients, 27(90.0%) had radiologically sufficient callus formation and 3(10.0%) patients had no sufficient callus formation. Functional outcome was satisfactory result (Excellent, Good and Fair) were 27(90.0%) and unsatisfactory result (poor) was 3 (10.0%). Conclusion: Finally, the result shows that in Gartland type-III closed supracondylar fracture of the humerus, closed reduction and stabilization by two lateral parallel percutaneous 'K'-wires is the good method for treatment.