Operative management of paediatric Supracondylar fractures of Humerus Extension type: The Results of K-wire Placement

Abstract

Aim: To study the k wire placement Cross Pinning Versus Lateral Pinning technique, in terms of functional outcome and complications in the operative management of paediatric supracondylar fractures of humerus extension type. Methodology: A total of 50 patients of supracondylar humerus fracture extension type-III were included in the study. 25 patients were operated by closed reduction with Cross K pinning fixation and 25 patients were operated by closed reduction and Lateral 2 K pinning fixation. All patients were followed up to 9 months and assessed for functional outcome and complications. Results: The two groups were comparable with respect to age /sex/weight/height and type of fractures. All patients of crosspinning were inmobilized for three weeks whereas in lateral pining 9% patients were immobilized for 4 weeks. The two groups were compared with respect to time till union, range of movement (ROM), carrying angle and function which was done at 3,6 and 9 months. 8.33% of the patients of cross pining group had ulnar nerve injury. 66.7% had excellent results in cross pinning compared to 70.6% in lateral pinning. Conclusion: There is no significant difference in the stability provided by the cross pinning and two lateral pin fixation method. But the medial and lateral pin fixation group shows two cases of iatrogenic ulnar nerve injury. Therefore, lateral pin fixation method for the treatment of type III supra condylar fracture requiring surgery is a reliable and safe method to avoid iatrogenic ulnar nerve injury and provides adequate stability if proper pin fixation principles are used.