Type III Supracondylar humeral fracture in children treated by 3 lateral versus 2 cross K-wire fixation, Aden, Yemen

Abstract

Background: Supracondylar fractures of humerus are the most common elbow fractures seen in children. Objective: To describe the patients’ condition and to evaluate the treatment and the outcome. Materials and method: We retrospectively reviewed the records of 40 consecutive patients with 40 displaced, supracondylar fractures of the humerus treated between January 2019 and December 2020, in Aden. The obtained data were sex, age, side of injury, time between injury and fixation, trial of reduction and complications. The collected data were tabulated and statistical analysis was done by estimating rates, means and standard deviations, Fisher test was used and p-value < 0.05 was considered as statistically significant. The statistical software package SPSS version 17 was used. Results: The total study patients were 40 patients. Twenty-one (52.5%) were males and 19 (47.5%) were females. The age of the patients ranged between 2 to 10 years and the mean age was 6.6 ± 2.1 years. Twenty-four (60%) had the fracture on the right arm, and 16 (40%) had it on the left arm. All the patients underwent surgery within 24 hours of injury. The mean time was 8.1 ± 4.5 hours. There were 11 (27.5%) cases of once trial reduction, 14 (35%) of twice trial reduction and 15 (37.5%) of three times trial reduction. The average removal of K-wires was 3.55 weeks. Twenty-six (65%) patients were treated by III lateral K-wires fixation and 14 (35%) were treated by crossed K-wire fixation. Post-operatively, (17.5%) patients got neuropraxia in the crossed K-wire group (n = 14), and none in the III lateral K-wire group. Two (5.0%) patients got angulation, one in the crossed K-wire group (n = 14), and one in the III lateral K-wire group (n = 26). Cupitus varus were seen in 2 (5.0%) patients in the crossed K-wire group and 2 (5.0%) in the III lateral K-wire group. Stiffness was found in the III lateral K-wire group with 2 (5.0%) patients. Conclusion: The delay in surgical treatment may cause a number of complications. Key words: Treatment, supracondylar fracture, humerus, children, Aden