Management of displaced supracondylar fractures of humerus in children: Closed reduction with external immobilization versus open reduction with k-wire fixation

Abstract

Introduction: Supracondylar fractures of humerus are the most common fracture pattern of elbow in children. Severely displaced supracondylar fractures of the distal humerus in children are a challenging problem. Many treatment methods have been described for treatment of displaced supracondylar fractures of humerus, however there is no clear consensus as regards choice of treatment. The purpose of this study is to asses and compare the results of closed reduction and cast application versus open reduction and internal fixation[ORIF] by K-wires for completely displaced supracondylar fractures [Gartland Type-III fractures ]. Materials and Methods: This prospective non-randomized comparative study was carried out over a period of 12 months in a sample size of 40 children at Rajendra Institute of Medical Sciences [RIMS], Ranchi. 20 children were treated by closed reduction and external immobilization and 20 by open reduction and internal fixation by K-wire. Patients were followed up for 6 months and functional outcome of the 2 groups were evaluated and compared using Flynn's criteria. Result: Most cases were in the age group of 5 to 8 years [67.5%]. In conservative group 8 patients [40%] had satisfactory results whereas in operative group 18 patients [90%] had satisfactory results. Conclusion: The present study shows that open reduction and K-wire fixation has better results compared to closed reduction and external immobilization for Type-III Supracondylar Fractures of humerus.