Management of irreducible supracondylar fracture of humerus in children

Nishant Kashyap; Wasim Ahmed; Indrajeet Kumar; Abhijeet Subhash; Pawan Kumar; Santosh Kumar

Volume : VII, Issue : VII, July - 2018

Management of irreducible supracondylar fracture of humerus in children

Nishant Kashyap, Wasim Ahmed, Indrajeet Kumar, Abhijeet Subhash, Pawan Kumar, Santosh Kumar

Abstract :

Background

Supracondylar fracture of the humerus is the most common elbow fracture in children. This fracture needs immediate diagnosis and treatment, otherwise, it may lead to significant neurovascular and functional problems. The aim of this study was to assess the short term outcome of displaced supracondylar fracture of the humerus in children by open reduction and pining from lateral approach.

Methods

During a period of 1 year from July 2016 to may 2017, 24 patients less than 10 years old were enrolled in the study. Inclusion criteria were extension type supracondylar fractures of humerus, Gartland typeII and III which were irreducible and failed in initial close reduction. The clinical and radiographic results of the treatment using open reduction and internal fixation by lateral K-wire fixation were evaluated. Outcomes were assessed according to the Flynn�s criteria.

Results

The average age of the patients was 6.3 years.The most prevalent range of age in this study, for both girls and boys 6-8 yrs. In 14 patients (60%), the left extremity was involved while, in the other 10 patients (40%) the right extremity was involved. 09 patients (37.5%) and 15 patients (62.5%) respectively, had involvement of the dominant and non-dominant extremity. According to the Flynn�s criteria, the cosmetic results in 21 out of 24 patients that completed their follow-up (87.5%) were excellent, in 2 patients (8.33%) were good and one case (4.16%) was fair (P=0.051). The functional results in 22 patients (91.67%) were excellent and in 2 patients (8.33%) were good (P=0.047).

Conclusion

Treatment of the supracondylar humeral fracture in children by open reduction and internal fixation through lateral pinning is a safe approach with predictable good clinical and radiographical results.