Closed reduction and Kirschner wire cross fixation for children with flexion-type supracondylar humeral fracture

Abstract

Objective To report the efficacy of closed pry reduction and cross Kirschner wiring in the treatment of refractory flexion-type fracture of supracondylar humerus in children. Methods A retrospective analysis was done of 19 children who had been treated for refractory flexion-type fracture of supracondylar humerus by closed pry reduction and cross Kirschner wiring at Department of Orthopaedics, Shaoyang Or-thopaedic Hospital from March 2015 to March 2017. They were 9 boys and 10 girls, aged from 2 to 12 years (mean, 6.37 years): 10 left and 9 right sides were involved. According to the severity of fracture displacement, 11 cases had rotational displacement with their broken ends obviously inserted into one another, and 8 cases complete displacement with no contact of the broken ends. All the fractures were closed, treated with closed reduction by leverage and cross fixation with Kirschner wire. Postoperative complications were recorded and the elbow function was evaluated by the Flynn assessment system at the last follow-up. Results The operation time for the 19 patients ranged from 15 to 60 minutes, with an average of 30 minutes. The patients were followed up for 12 to 24 months (average, 18.0 months). All the fractures united after 2 to 4 months (average, 2.8 Months). At the last follow-up, according to the Flynn system, the elbow function was evaluated as excellent in 10 cases, good in 7, and fair in 2. No ossifying myositis, cubitus varus or iatrogenic injury to the ulnar nerve was observed in any patient. Nails had to be removed in one case due to implant loosening after pin-hole infection. Conclusion Closed reduction and Kirschner wire cross fixation is an ideal surgical treatment for refractory flexion-type supracondylar fracture of humerus in children, because its intraoperative closed pry reduction can reduce the rate of incision. Key words: Humeral fractures; Elbow joint; Bone nails; Reduction