Anand Narayanan1, Subramanian Vaidyanathan2
BACKGROUND
Supracondylar fracture of humerus is a common fracture in children. Closed
manipulative reduction and percutaneous K-wire fixation is the most widely
recognized treatment method for displaced supracondylar humerus fracture in
children but controversy persists regarding the ideal pin fixation technique. The
purpose of this study was to compare the radiological and functional outcome of
lateral entry pinning with that of crossed pinning fixation for Gartland type III
supracondylar humerus fractures in children.
METHODS
This prospective cohort study was conducted in Govt. Medical College Hospital,
Thiruvananthapuram from February, 2015 to September, 2016. A total of 54
patients who satisfied the inclusion and exclusion criteria were enrolled in the
study. They were allocated to Group A (crossed pin fixation) and Group B (lateral
pin) fixation with 27 patients in each. All the cases of percutaneous pinning were
done according to a uniform standardized technique. The patients were reevaluated
at post-operative day, three weeks, and three months after the surgery.
Following information were recorded as outcome measures: (i) carrying angle (ii)
range of motion (iii) modified Flynn’s criteria. (v) Baumann’s angle (vi)
neurovascular injury.
RESULTS
There was no statistically significant difference between crossed and lateral
pinning with regard to mean Baumann's angle, carrying angle, complication rate,
stability and functional outcome, but there was evidence of iatrogenic ulnar nerve
injury (3.7 %) in crossed pinning group. There was one case of pin tract infection.
CONCLUSIONS
There is no statistically significant difference between the radiological and
functional outcome provided by crossed pin fixation method and lateral pin fixation
methods. Closed reduction and percutaneous pin fixation are safe and efficient
methods for fixation of displaced supracondylar fractures of the humerus. Closed
reduction and percutaneous pin fixation for displaced supracondylar factures of
the humerus in children gives good functional and cosmetic results.
