Role of Closed Reduction & Internal Fixation in Supracondylar Fractures of the Humerus

Abstract

Background: Displaced supracondylar fractures have a high rate of displacement and if not reduced and stabilized in optimal position may lead to serious residual deformity. No general agreement on the treatment is evident with controversy prevailing regarding the ideal timing of surgery, method of maintenance of reduction and configuration of the pin fixation. Materials And Methods: Twenty Four males and Eight females with ages ranging from 3-12 years who required closed reduction and internal fixation using percutaneous Kirschner wire for fresh displaced supracondylar fractures of humerus between March 2012 -Dce 2015 were selected. The Kirschner wires were passed percutaneously under C-Arm control from the lateral epicondyle in varying geometry or configuration to achieve fracture stability. Each patient was followed up for at least one years and results were graded using the Flynn’s criteria. They were graded as excellent in 28 (87.50%) cases, good in 03(09.38%) cases and only 01 (03.12%) case had a poor result, there were no fair results at the end of final follow up. Conclusion: Treatment of the supracondylar humeral fracture in children by closed reduction and internal fixation is a safe approach with predictable good clinical and radiographical results. Key-words: Anatomical reduction, Percutaneous Fixation, Baumann’s angle, Humerus supracondylar fracture and closed reduction. Introduction Supracondylar fracture of the humerus is almost exclusively a fracture of the immature skeleton, seen in children and young teenagers 1 . Supracondylar fractures of the humerus in children are difficult to treat. Closed reduction is both difficult to achieve and maintain, because of the thinness of bone at the distal third between the coronoid and olecranon, where most supracondylar fractures tend to occur. Various methods have been described for the reduction of the fracture, such as reduction of the fracture by manipulation in flexion 2 , milking maneuver to disengage the proximal fragment from the soft www.jmscr.igmpublication.org Impact Factor 5.244 Index Copernicus Value: 5.88 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: http://dx.doi.org/10.18535/jmscr/v4i6.10