THE OUTCOME OF THREE LATERAL DIVERGENT PINNING VS PARALLEL PIN FIXATIONS FOR THE TREATMENT OF DISPLACED SUPRACONDYLAR HUMERUS FRACTURES IN CHILDREN.

Abstract

Supracondylar humerus fracture is the most common type of elbow fracture in children younger than 15 years. This hospital based prospective study evaluated different pinning xations which is used in the treatment of Gartland Type II and Gartland Type III supracondylar humeral fractures in children with closed fractures ≤7 days old, extension type, for comparing clinical, radiological and functional outcome of lateral parallel and divergent pinning for displaced supracondylar fractures in children.The study was conducted from May 2021 to May 2022. The mean age was 8.2 years for Divergent pinning group and for Parallel pinning group, the mean age was 9.2 years. Functional outcome were measured using Flynn's criteria & radiological outcome measured using Baumanns angle & carrying angle. Divergent pinning group had 12 males and 7 females while Parallel pinning group had 15 males and 5 females. The time interval between injury and surgery was less than 12 hours in 84.21% of Divergent pinning group & 95% in Parallel pinning group. In our study the duration of surgery was less than 35 minutes in 68.5% in Divergent pinning group and 85% in Parallel pinning group. Patients were followed up clinicoradiologically at 3 weeks, 6 weeks, 3 months & 6 months post operatively & assessed for elbow function, carrying angle, rate of union etc., during each follow up. In our study divergent pinning gave better results than parallel pinning as the latter encountered slower rate of union and varus deformities (loss of carrying angle and baumanns angle).