Journal of Orthopedics and Joint Surgery

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VOLUME 3 , ISSUE 1 ( January-June, 2021 ) > List of Articles

Original Article

Functional and Radiological Outcome of Displaced Supracondylar Humerus Fracture in Children: A Prospective Observational Study

Faiz Khan, Nandakumar Rengarajan, Muthulingam Manoharan, Dhanasekaran Rajarajan

Citation Information : Khan F, Rengarajan N, Manoharan M, Rajarajan D. Functional and Radiological Outcome of Displaced Supracondylar Humerus Fracture in Children: A Prospective Observational Study. 2021; 3 (1):18-22.

DOI: 10.5005/jp-journals-10079-1046

License: CC BY-NC 4.0

Published Online: 07-07-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Introduction: Around 60% of all the elbow injuries in the first decade, supracondylar fractures of the humerus are the most widely recognized elbow injuries in youngsters. Accompanied with problems like compartment disorder, neurovascular harm, Volksman's ischemic contracture, and malunion. The most widely recognized choice of pinning is either cross-pin fashion or two parallel pins. Closed reduction and percutaneous K-wire fixation are best with the least problems in contrast with different modalities. In our study, we want to assess the functional and radiological outcome of pediatric displaced supracondylar humerus fracture treated with closed reduction percutaneous K-wire fixation. Materials and methods: Sixteen patients were selected for the study based on the inclusion and exclusion criteria based on the consecutive sampling. For all patients, the standard technique of percutaneous k wire fixation was performed, and patients were evaluated on 6 weeks, 3 months, and 6 months with functional scoring by Flynn et al. Criteria and Mayo elbow scoring and radiological scoring with Baumann's angle. Results: Ten children (62.5%) were affected in their first decade of life, with a clear male predilection than females. Mayo elbow scoring was 2.5, 6.0, and 3.75 at 6 weeks, 3 months, and 6 months. Pin-tract infection (4), two cases of malunion of our study population. In all 16 cases, the union was achieved with 14 cases satisfactorily excellent and satisfactorily good in 1 case and unsatisfactorily poor in 1 case. Conclusion: Closed reduction and percutaneous pinning are the treatment of choice for pediatric supracondylar humerus fractures with Modified Gartland's type II and type III. Appropriate pinning technique ensures a successful outcome with cross configuration providing excellent outcome with good rotational stability. Closed reduction and percutaneous pinning is a safe, cost-effective, less morbid procedure.

  1. MacEwen GD. Tachdjians pediatric orthopaedics, 3rd ed. volumes 1, 2, and 3. J Bone Joint Surg Am Vol 2002;84(6):1104. DOI: 10.2106/00004623-200206000-00043.
  2. Kocher MS, Kasser JR, Waters PM, et al. Lateral entry compared with medial and lateral entry pin fixation for completely displaced supracondylar humeral fractures in children: a randomized clinical trial. J Bone Joint Surg Series A 2007;89(4):706–712. DOI: 10.2106/JBJS.F.00379.
  3. Ramachandran M, Skaggs DL, Crawford HA, et al. Delaying treatment of supracondylar fractures in children: has the pendulum swung too far? J Bone Joint Surg Br Vol 2008;90(9):1228–1233. DOI: 10.1302/0301-620X.90B9.20728.
  4. Krusche-Mandl I, Aldrian S, Köttstorfer J, et al. Crossed pinning in paediatric supracondylar humerus fractures: a retrospective cohort analysis. Int Orthop 2012;36(9):1893–1898. DOI: 10.1007/s00264-012-1582-x.
  5. Cheng JC, Lam TP, Maffulli N. Epidemiological features of supracondylar fractures of the humerus in Chinese children. J Pediatricorthoped Part B 2001;10(1):63–67. DOI: 10.1097/00009957-200101000-00011.
  6. Mahan ST, May CD, Kocher MS. Operative management of displaced flexion supracondylar humerus fractures in children. J Pediat Orthop 2007;27(5):551–556. DOI: 10.1097/01.bpb.0000279032.04892.6c.
  7. Brauer CA, Lee BM, Bae DS, et al. A systematic review of medial and lateral entry pinning versus lateral entry pinning for supracondylar fractures of the humerus. J Pediat Orthop 2007;27(2):181–186. DOI: 10.1097/bpo.0b013e3180316cf1.
  8. SWENSON AL. The treatment of supracondylar fractures of the humerus by Kirschner-wire transfixion. J Bone Joint Surg Am Vol 1948;30A(4):993–997. DOI: 10.2106/00004623-194830040-00023.
  9. Guy SP, Ponnuru RR, Gella S, et al. Lateral entry fixation using three divergent pins for displaced paediatric supracondylar humeral fractures. ISRN Orthopedics 2011;2011:1–5. DOI: 10.5402/2011/137372.
  10. Lee S, Mahar A, Miesen D, et al. A biomechanical comparison of three pin configurations for percutaneous stabilization of pediatric supracondylar humerus fractures. Orthop Res Soc 2001.
  11. Prashant K, Lakhotia D, Bhattacharyya T, et al. A comparative study of two percutaneous pinning techniques (lateral vs medial–lateral) for Gartland type III pediatric supracondylar fracture of the humerus. J Orthop Traumatol 2016;17(3):223–229. DOI: 10.1007/s10195-016-0410-2.
  12. Afaque SF, Singh A, Maharjan R, et al. Comparison of clinic-radiological outcome of cross pinning versus lateral pinning for displaced supracondylar fracture of humerus in children: a randomized controlled trial. J Clin Orthop Trauma 2020;11(2):259–263. DOI: 10.1016/j.jcot.2019.01.013.
  13. Naik LG. Cross pinning versus lateral pinning in the management of type III supracondylar humerus fractures in children. J Clin Diagnos Res 2017;11(8):RC01–RC03. DOI: 10.7860/JCDR/2017/28481. 10351.
  14. Li Y-A, Lee P-C, Chia W-T, et al. Prospective analysis of a new minimally invasive technique for paediatric Gartland type III supracondylar fracture of the humerus. Injury 2009;40(12):1302–1307.
  15. Sinikumpu J-J, Victorzon S, Pokka T, et al. The long-term outcome of childhood supracondylar humeral fractures. The Bone & Joint Journal [Internet]. 2016;98-B(10):1410–1417.
  16. Ulmar B, Brunner A, Kocak T, et al. Behandlungsergebnisse operativ versorgter kindlicher suprakondylärer Humerusfrakturen. Zeitschrift für Orthopädie und Unfallchirurgie. 2012;150(05):488–494.
  17. Lee B-J, Lee S-R, Kim S-T, et al. Radiographic outcomes after treatment of pediatric supracondylar humerus fractures using a treatment-based classification system. J Orthop Trauma 2011;25(1):18–25. DOI: 10.1097/BOT.0b013e3181db7d70.
  18. Kitta MI, Ismiarto YD, Saleh MR, et al. Analysis of radiological alignment and functional outcomes of pediatric patients after surgery with displaced supracondylar humerus fracture: A cross-sectional study. Int J Surg Open 2020;24:136–142.
  19. Gopinathan NR, Sajid M, Sudesh P, et al. Outcome analysis of lateral pinning for displaced supracondylar fractures in children using three kirschner wires in parallel and divergent configuration. Indian J Orthop 2018;52(5):554–560.
  20. Devkota P, Khan JA, Acharya BM, et al. Outcome of supracondylar fractures of the humerus in children treated by closed reduction and percutaneous pinning. J Nepal Med Assoc 2008;47(170): 66–70.
  21. Lee JS. Treatment of completely displaced supracondylar fracture of the humerus in children by cross-fixation with three kirschner wires. J Pediatr Orthop 2002;22(1):12–16.
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