Outcome of Type III Supracondylar Humerus Fracture Treatment by Closed Reduction and Different Configuration of Percutaneous K-wire Technique in Children

Abstract

Introduction: Supracondylar humerus fractures comprise 17% of all pediatric fractures and are second in frequency to forearm fractures. According to an epidemiological study, the incidence of fracture supracondylar humerus is 308/100000/year in the general population. It is also the most common pediatric fracture around the elbow. Fracture involving lateral condyle shows swelling, tenderness, and crepitus over lateral condyle, whereas in supracondylar fracture, tenderness and swelling involve medial supracondylar ridge and the lateral supracondylar ridge. Objectives: (1) To assess mechanical stability and functional mobility in cross, lateral divergent, lateral parallel, and three-pin Kirschner wire fixation. (2) To assess radiological outcome in cross, lateral divergent, lateral parallel, and three-pin Kirschner wire fixation. Materials and Methods: This cross-sectional study was conducted in the hospital attached to Government Bundelkhand Medical College, Sagar, Madhya Pradesh, from July 2021 to August 2022. During this period, 60 cases of displaced supracondylar fractures of the humerus in children were treated with cross pinning and lateral pinning with Kirschner wires according to odd and even randomization. Results: A total of 60 participants were selected with a mean age of 8.6 (±2.6) years, a minimum was 4 years, and maximum were 12 years. Thirty-nine was male and 21 was female. Out of 60 cases, 17 (28.3%) cases were operated by two cross K-wire, 18 (30%) were by two lateral k-wire divergent, 15 (25%) were by two lateral K-wire parallel, and 10 (16.7%) cases were operated by three-pin (2 lateral and 1 medial). The carrying angle of the normal elbow was 11.8 ± 1.9, 11.9 ± 2.4, 11.0 ± 1.6, 11.7 ± 1.8 among two cross K-wire and two lateral (divergent), two lateral (parallel), three-pin K-wire groups, respectively. The differences in the angle in these groups were not statistically significant. Conclusion: In our study, two lateral divergent K-wire or two lateral parallel K-wire fixation method provided safe, better functional and radiological outcomes as well as equal mechanical stability as compared to two cross K-wire or three pinning in most of the patients.

Keywords

• supracondylar humerus fracture
• type iii
• closed reduction
• shf
• k-wire