.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.jpg)
Outcome of Supracondylar Fractures of Humerus in children treated with Dorgan’s Surgical Technique
Keywords:
Dorgan’s technique, Flynn’s criteria, Supracondylar fracture, Ulnar nerveAbstract
Objective: To determine the functional and radiological outcome of supracondylar fractures humerus in children treated with Dorgan’s lateral cross pinning technique.
Methods: This descriptive study was carried out at Orthopaedic division Lady Reading Hospital Peshawar and Rahman medical and surgical center Buner Khyber Pakhtunkhwa Pakistan from 2nd June 2017 to 20th June 2019. All children with supracondylar fracture humerus meeting the inclusion criteria were fixed with Dorgan’s lateral k wires stabilization technique. Post operative outcome was assessed with X rays for union/malunion and functionally with Flynn’s criteria and graded as excellent, good, fair and poor.
Results: A total of 30 children with mean age 4.90 ± 2.48 years were included in our study. Boys were 20(66.7%) and girls 10(33.3%). There were 11 (36.7%) Gartland type II and 19 (63.3%) Gartland type III fractures.Post operatively radiological union was achieved in all patients. Excellent results were achieved in 22(73.3%), good in 5(16.6%) and fair in 3(10%) patients. No ulnar nerve or radial nerve injury was noted.
Conclusion: Excellent and good functional and radiological results were achieved with Dorgan’s lateral cross pinning technique. We recommend this technique as first line treatment option to stabilize supracondylar humerus fractures in children.
References
2. de Neira JZ, Prada-Cañizares A, Marti-Ciruelos R, Pretell-Mazzini J. Supracondylar humeral fractures in children: current concepts for management and prognosis. International Orthop. 2015 ;39(11):2287-96.
3. Larson AN, Garg S, Weller A, Fletcher ND, Schiller JR, Kwon M, Browne R, Copley LA, Ho CA. Operative treatment of type II supracondylar humerus fractures: Does time to surgery affect complications? J Ped Orthop. 2014;34(4):382-7.
4. Swenson AL. The treatment of supracondylar fractures of the humerus by Kirschner-wire transfixion. J Bone J Sur Am. 1948;30(4):993-7.
5. Flynn JC, Matthews JG, Benoit RL. Blind Pinning of Displaced Supracondylar Fractures of the Humerus in Children: Sixteen Years experience with Long-Term Follow-Up. J Bone J Sur Am. 1974;56(2):263-72.
6. Nacht JL, Ecker ML, Chung SM, Lotke PA, Das M. Supracondylar fractures of the humerus in children treated by closed reduction and percutaneous pinning. Clin Orthop Relat Res. 1983(177):203-9.
7. Topping RE, Blanco JS, Davis TJ. Clinical evaluation of crossed-pin versus lateral-pin fixation in displaced supracondylar humerus fractures. J Ped Orthop. 1995;15(4):435-9.
8. Arino VL, Lluch EE, Ramirez AM, Ferrer JO, Rodriguez LU, Baixauli FR. Percutaneous fixation of supracondylar fractures of the humerus in children. J Bone J Sur Am. 1977;59(7):914-6.
9. Zionts LE, McKellop HA, Hathaway R. Torsional strength of pin configurations used to fix supracondylar fractures of the humerus in children. J Bone J Sur Am. 1994;76(2):253-6.
10. Shannon FJ, Mohan P, Chacko J, D’Souza LG. “Dorgan’s” percutaneous lateral cross-wiring of supracondylar fractures of the humerus in children. J Ped Orthop. 2004 ;24(4):376-9.
11. Altay MA, Erturk C, Isikan UE. Comparison of traditional and Dorgan’s lateral cross wiring of supracondylar humerus fractures in children. Saudi Med J. 2010; 31(7): 793-796.
12. Celiker O, Pestilci FI, Tuzuner M. Supracondylar fractures of the humerus in children: Analysis of the results in 142 patients. J Orthop Trauma. 1990;4(3):265-9.
13. Eid AM. Reduction of displaced supracondylar fracture of the humerus in children by manipulation in flexion. Acta Orthopaedica Scandinavica. 1978;49(1):39-45.
14. Pirone AM, Graham HK, Krajbich JI. Management of displaced extension-type supracondylar fractures of the humerus in children. J Bone J Sur Am. 1988 Jun;70(5):641-50.
15. Damelsson L, Petterssox H. Open reduction and pin fixation of severely displaced supracondylar fractures of the humerus in children. Acta Orthopaedica Scandinavica. 1980;51(1-6):249-55.
16. Aronson DD, Prager BI. Supracondylar fractures of the humerus in children. A modified technique for closed pinning. Clin Orthop Relat Res. 1987:174-84.
17. El-Adl WA, El-Said M, Boghdady GW, Ali AM. Results of treatment of displaced supracondylar humeral fractures in children by percutaneous lateral cross-wiring technique.Strategies in Trauma and Limb Reconstruction. 2008;3(1):1-7.
18. Memisoglu, K., Cevdet Kesemenli, C, Atmaca, H. Does the technique of lateral cross-wiring (Dorgan’s technique) reduce iatrogenic ulnar nerve injury? International Orthopaedics (SICOT). 2011;35(3):375-378.
19. Queally JM, Paramanathan N,.Walsh JC, Moran CJ, Shannon FJ, D'Souza LG. Dorgan's lateral cross-wiring of supracondylar fractures of the humerus in children: A retrospective review.Injury. 2010;41(6):568-571.
