Management of displaced supracondylar fracture of humerus in children by closed reduction and k wire fixation

Abstract

Supracondylar fracture of humerus is a common pediatric elbow injury contributing 60-70% of all elbow injuries. The management of displaced supracondylar fracture of the humerus is one of the most difficult of the many fractures seen in children. Displaced fractures are inherently unstable. Conservative treatment often results in malunion. Open reduction and internal fixation is more invasive and recovery is prolonged. Closed reduction and percutaneous pinning is the preferred method of treatment for displaced type 3 supracondylar fractures in children. This study was done to know the age, sex, side of involvement, mode and mechanism of injury, anatomical and functional results of treatment of this type 3 fractures by closed reduction and percutaneous pinning and also the complications of this procedure. 30 cases of displaced supracondylar fractures of humerus in children who attended in first 24 hours of injury were managed by closed reduction and percutaneous k wire fixation under image intensifier with in 8hours were studied. Out of 30 cases 24 cases had excellent results, 6 cases have good results, according to modified Flynn’s criteria. One patient developed ulnar nerve palsy which was iatrogenic, and improved completely after wire removal. Another was brachial artery injury which was explored and recovered completely. This concludes closed reduction and percutaneous k wire fixation is a safe and reliable technique for obtaining and maintaining an excellent reduction in this difficult fracture.