Comparing Lateral Versus Both Medial and Lateral Percutaneous K-Wire Fixation of Displaced Supracondylar Humerus Fracture in Paediatric Patients

Abstract

Supracondylar humerus fractures are the most common injuries in paediatric age group. For displaced fractures [III and IV], closed reduction and internal fixation with K-wires is the most preferred option. The current study aims to compare the outcomes of the management of Gartland type III and IV supracondylar humerus fractures with crossed and lateral pinning. We included 40 patients in our study between the age of 2-12 years with Gartland Type III and IV fractures, Weight < 40 kg, less than 10 days old, closed fractures. Randomization was done where the Odd numbered patients were put in Group 1 and even number in Group 2. Group 1 participants were managed by lateral K-wire fixation and Group 2 by crossed K-wire fixation. All the patients were assessed for any loss of reduction and iatrogenic neurovascular injuries, alignment, Flynn’s criteria, Mayo elbow score. The flexion-extension range in Group 1 was about 110.27° ± 14.39° as compared to 103° ± 12.05° in Group 2. Supination to pronation was about 87.7° ± 1.62° in Group 1 as compared to 87° ± 2.42° in Group 2. Functionally (p>0.05) and radiographically both groups did not show any significant difference. Thus, we concluded that lateral pinning in good hands is as stable as crossed pinning with lower chances of nerve injury and is relatively safe.