Closed Reduction and Lateral Percutaneous Pin Fixation for Displaced Supracondylar Humerus Fractures in Children

Document Type : Original Article

Authors

1 Orthopedic surgery, Zagazig University, Zagazig, Egypt

2 Professor of Orthopedic Surgery Faculty of Medicine - Zagazig University

3 Orthopedic Surgery Department Faculty of Medicine; Zagazig University Zagazig, Egypt

Abstract

Background: Lateral percutaneous pin fixation of Supracondylar humerus fracture (SCHF) is usually performed after accepted closed reduction. The aim of this study was to achieve fracture stability, maintained reduction and satisfactory results while minimizing the risk of iatrogenic ulnar nerve injury. Patients and methods: Twenty patients with extension Gartland type II and III SCHFs managed by closed reduction and lateral percutaneous pinning from December 2016 to December 2017 were enrolled in single center, prospective, observational, randomized controlled clinical trial. Postoperative immobilization was with an above elbow back splint and an arm sling. On days 1, 7, 14, and 21; obtained radiographs were evaluated. Results: according Flynn’s criteria; all cases had satisfactory functional and cosmetic results. Only one case of a local infection was reported and treated with antibiotic therapy. Currently, all patients could perform daily activities. Discussion: lateral pinning technique had achieved fracture stability, maintenance of reduction and alignment, satisfactory functional and anatomical results in the form of a cosmetically accepted upper limb with normal range of movement while minimizing the risk of neurovascular complications as iatrogenic ulnar nerve injury in displaced SCHFs in children. Conclusion: With anatomic reduction and stable fixation, CRPP with lateral-entry K-wires fixation of pediatric SCHFs is similar to the conventional cross-wire fixation in terms of the stability, but superior in terms of ulnar nerve safety, hence giving excellent results. Level of evidence: V prospective randomized controlled study.

Keywords

Zagazig University Medical Journal
Volume 26, Issue 2
Surgery - Obstetrics & Gynecology - Radiological Sciences
March 2020
Pages 233-238

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