Management of Displaced Supracondylar Humeral Fractures in Children by Open Reduction and Internal Fixation with K-Wires: A Prospective Study

Abstract

Background: Supracondylar fractures of humerus are the commonest injury, constitutes about 65.4% of all fractures around the elbow in children. Displaced supracondylar fracture of humerus demand great respect and challenging one to treat, since it requires accurate anatomical reduction and internal fixation to prevent complications. We reported the results of open reduction and internal fixation with K-wires of the displaced (Gartland’s type III) supracondylar humeral fractures in children. Objectives: To study the anatomical and functional results of treatment of supracondylar fracture of humerus by open reduction and internal fixation with K-wires. Methods: 25 cases of displaced (Gartland’s type III) supracondylar fractures treated by open reduction and internal fixation with K-wires were studied between September 2011 – August 2013 at PES Institute of Medical Sciences & Research and followed for an average of 24 months. Results: In our study of 25 patients, all were closed Gartland’s type III fractures with mean age of 6.3 years, 13 patients sustained fracture due to fall while playing, 18 had on left side, with posteromedial displacement in 16 patients. 2 patients had associated distal end radius fracture. Majority of patients operated on 2nd day and discharged on 3rd postoperative day. 3 patients had superficial pin tract infection, 2 had traumatic median nerve palsy, 2 had migration of K-wire, 1 had cubitusvarus deformity and 1 had loss of motion >150. Conclusion: Open reduction and internal fixation with K-wires gives more stable fixation, better anatomical reduction with negligible complication and can be accepted asthe best method of treatment for irreducible type 3 supracondylar humerus fracture. Keywords: Supracondylar fracture, Gartland’s type III, humerus, open reduction, internal fixation, and Flynn’s criteria