Open reduction and internal fixation with k-wire in type III supracondylar fracture of humerus in children by posterior approach

Abstract

Background: Supracondylar fractures of humerus are the most common fractures seen in children. Severely displaced supracondylar fractures of the distal humerus in children are a challenging problems. Displaced supracondylar fractures are notorious for difficulty in reduction, maintenance of reduction and involvement of neurovascular structures. Open reduction and internal fixation is applied when closed reduction fails to give satisfactory reduction. The aim of the study was to determine the cosmetic and functional results following open reduction and internal fixation with k-wire for type III supracondylar fractures of the humerus by posterior approach. Method: Twenty cases of type III supracondylar fractures of humerus were included in the study. The mean age of the patients was 8.4 yrs (ranges from 5-14 years). The male to female ratio was 2:1 and left side was involved in 14 cases and 6 had right sided injuries. All fractures were of extension type (gartland, s type III). Open reduction and internal fixation with k-wire was performed by posterior approach. K-wires were removed between 3- 4 weeks post operatively and follow up was done at 6wks, 12 wks, 6 months and 12 months. The results were graded using the criteria described by Flynn et al.Results: Excellent results were achieved in 11 pts (55%), good in 4 pts (20%), fair in 2 pts (10%), while poor results were seen in 3 pts (15%).Conclusion: Open reduction and internal fixation with k-wires by posterior approach in type III supracondylar fractures of humerus in children is satisfactory.