Outcome of Open Reduction and Internal Fixation of Gartland III Supracondylar Fractures of The Humerus in Children Using Crossed K Wires Via Medial Incision

Authors

  • Muhammad Shahbaz Raza Department of Orthopaedics & Trauma , CMH , Muzaffarabad
  • Naveed Hassain Syed Department of Orthopaedics & Trauma , CMH , Muzaffarabad
  • Shoukat Hayat Khan Department of Orthopaedics & Trauma , CMH , Muzaffarabad
  • Zubair Ahmad Khan Department of Orthopaedics & Trauma , CMH , Muzaffarabad

Keywords:

Supracondylar fractures of humerus; medial incision, Open reduction.

Abstract

Objective: To assess the Radiological & Functional outcome of open reduction and internal fixation with crossed K Wires in Gartland III displaced Fractures Supracondylar humerus in children using medial approach.

Method: It was a prospective study conducted on 95 patients with displaced supracondylar fractures of the humerus Gartland III in children. All patients were managed with open reduction and internal fixation using crossed K Wires via medial approach.

The most common mechanism of trauma was fall while playing; fall from height and road traffic accident. The mean follow-up time was six months and results were assessed according to Flynn’s criteria.

Results: Total 95 patients with closed supracondylar fractures of the humerus Gartland III were included in this study. Male to female ratio was 56:39 (59 %:41 %). 50 (52.6 %) patients got trauma to their right elbow while left elbow was involved in 45 (47.4 %) of cases. The mean age of the patients was 7.5+2.08 years. 60 (63.15%) patients gained excellent results according to Flynn’s criteria while 17 (17.90%) patients had good and 13 (13.69%) patients achieved satisfactory results. Only 5 (5.26%) patients had poor results. The main cause of poor results was late presentation and initial quack management. No case of neurovascular injury and cubitus varus deformity was reported. All patients were happy with their scar appearance.

Conclusion: Management of displaced supracondylar fractures of the humerus in children with Open reduction and internal fixation using medial incision is simple, safe and straightforward, providing more anatomical reduction and functional outcome with good scar cosmoses.

References

1. Pretell Mazzini J, Rodriguez Martin J, Andrew-Esteban EM. Surgical approaches for open reduction and pinning in severely displaced supracondylar humerus fractures in children: a systemic review. J Child Orthop 2010 Apr:(4)2:143-52.
2. Loizou C, Simillis C, Hutchinson J. A systemic review of the early versus delalyed treatment for type III Supracondylar humeral fractures in children. Injury. 2009 Mar;40(3):245-48.
3. De Buys Roessingh AS, Reinberg O. Open or closed pinning for distal humerus fractures in children? Swiss Surg 2003;9:76-81.
4. Tiwari A, Kanajia RK, Kapoor SK. Surgical management for late presentation of Supracondylar humerus fractures in children. J Ortho Surg (Hong Kong).2007 Aug;15(2):177-82.
5. Arnio VL, Lluch EE, Ramirez AM, Ferrer J, Rodriguez L, Baixauli F. Percutaneous fixation of supracondylar fractures of the humerus in children. J Bone Joint Surg 1977 Oct;59: 914-6.
6. Otsuka NY, Kaseer Jr. Supracondylar fractures of the humerus in children. J Am Acad Orthop Surg 1997; 5: 19-26.
7. Sibly t, Briggs p, Gibson M. Supracondylar fractures of the humerus in childhood; range of movement following the posterior approach to open reduction. Injury. 1991 Nov;22(6): 456-58.
8. Hussain S, Ahmad M, Muzaffur T. Open reduction and internal fixation for displaced of the humerus in children with crossed K wires using lateral approach. Chin J Traumatol .2014;17(3):130-35.
9. Eren A, Guven M, Erol B, Cakar M. Delayed surgical treatment of supracondylar fractures in children using a medial approach. J Child Orthop. 2008 Feb;2(1):21-27.
10. Mazzini JP, Martin JR, Esteban EMA. Surgical approaches for open reduction and pinning in severely displaced supracondylar humerus fractures in children: a systemic review. J Child Orthop. 2010 Apr;4(2):143-52.
11. Flynn J C, Matthews J G, Benoit R L. Blind pinning of displaced supracondylar fractures of the humerus in children. J Bone Joint Surg Am 1974 Mar;56:263-72.
12. Mazda K, Boggione C, Fitoussi F, Pennicot GF. Systemic pinning of displaced extension-type supracondylar fractures of the humerus in children. A prospective study of 116 consective patients [J]. J Bone joint Surg Br 2001 Aug;83(6):888-93.
13. Ramsey RH. Griz J. Immediate open reduction and internal fixation of severely displaced supracondylar fractures of the humerus in children. Clin orthop Relat Res 1973 Jan-Feb;(90):131-2.
14. Shirfin PG, Gehring HW, Iglesias LJ. Open reduction and internal fixation of displaced supracondylar fractures of the humerus in children. Orthop Clin North Am 1976;7(3):573-81.
15. Barlas K, George B, Hashmi F, Bagga T. Open medial placement of krishner wires for supracondylar humerakl fractures in children. J Orthop Surg 2006;14:53-7.
16. Kohler r, Ducret H, Willemen L. Cubitus Varus post traumatique. In: Damsin JP, Langlais J, editors. Traumatologie du coude de L’enfant. Cahier d’enseignement de la SOF-COT n 72. Paris: Expansion Scientifique francaise; 2000. P210-21.
17. Labella H, Bunnell WP, Duhaine M, Poitras. Cubitus varus deformity following supracondylar fractures of the humerus in children. J Pediatr orthop 1982;2(5):539-46.
18. Minkowitz B, Busch MT. Supracondylar humerus fractures. Current trends and controversies. Orthop Clin North Am 1994;25(4):581-94.
19. Carcassone M, Bergoin M, Hornung H. Results of operative treatment of severe supracondylar fractures of the elbow in children. J Pediatr Surg 1972;7(6):676-9.
20. Weiland AJ, Meyer S, Tolo VT, Berg HL, Mueller J. Surgical treatment of displaced supracondylar fractures of the humerus in children. Analysis of fifty-two cases followed for five to fifteen years [J]. J Bone Joint Surg Am 1978 Jul;60(5):657-61.
21. Shaw BA, Kasser JR, Emans JB. Management of vascular injuries in displaced supracondylar humerus fractures without arteriography. J Orthop Trauma 1990;4(1):25-9.
22. Sibly TF, Briggs PJ, Gibson MJ. Supracondylar fractures of the humerus in childhood: range of movement following the posterior approach to open reduction. Injury 1991;22(6):456-8.
23. Gruber MA, Hudson OC. Supracondylar fractures of the humerus in childhood. J Bone Joint Surg Am 1964;46(6):1245-52.
24. Royce RO, Dutkowsky JP, Kasser JR, Rand FR. Neurologic complications after K-wire fixation of supracondylar humerus fractures in children. J pediatr orthop 1991;11(2):191-4.
25. Lyons JP, Ashley E, Hoffer MM. Ulnar nerve palsies after percutaneous cross-pinning of supracondylar fractures in children’s elbow. J pediatr orthop 1998;18(1):43-5.

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Published

2019-01-02

Conference Proceedings Volume

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Original Articles

How to Cite

Outcome of Open Reduction and Internal Fixation of Gartland III Supracondylar Fractures of The Humerus in Children Using Crossed K Wires Via Medial Incision. (2019). Journal of Pakistan Orthopaedic Association, 30(03), 111-116. https://jpoa.org.pk/index.php/upload/article/view/219

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