Functional and Radiological Outcome in Displaced Supracondylar Humerus Fracture in Children Treated with Closed Reduction and Lateral or Cross Pinning- A Retrospective Study

Abstract

Background: Supracondylar Humerus Fracture (SCHF) is frequently encountered in pediatric age group and nearly three fourth of all upper extremity fractures. Most commonly used technique for surgical treatment in the displaced SCHF in children is closed reduction and stabilization with percutaneous pins. Aim: This retrospective study was conducted to find out the outcome and safety of percutaneous pinning techniques which includes lateral pinning and cross pinning in terms of functional and radiological outcome and to see the associated complications with this method of fixation. Materials and Methods: This retrospective study comprising of 26 cases of displaced supracondylar fracture, treated with lateral or cross pinning was carried out at Orthopedics Department, Gujarat Adani Institute of Medical Sciences and G.K General Hospital, Bhuj from May 2019 to April 2020. The inclusion criteria were: a) Gartland extension type II, III, b) age below 12 years, c) presented to OPD/Emergency within 72 hours of injury, d) closed and gustilo grade I open fractures, Patients with: a) Extension Type I of fractures, b) flexion type injuries, c) except Gustilo grade 1 open fracture d) age more than 12 year e) pervious history of fractures or nerve injury around the elbow, were excluded from the study. Postoperative immobilization was with an above elbow back splint and an arm sling. Flynn’s score was used to measure outcome. Results: Out of the 26 patients, 18 were male and 8 were female. The children were aged 2 years to 12 years with a median age of 8.07 years. Out of all cases, 3 cases were treated by two lateral k-wires while 19 were treated by 3 lateral k-wires while only four cases were treated with cross pinning. According Flynn’s criteria; satisfactory functional results in our study were 54% of cases had excellent results, 38% had good results and 8% had a fair result. 42% of cases had excellent cosmetic results were 54% of cases had good results and 4% had a fair result. Conclusion: In our study, we found that anatomical reduction and intra- operative stability will dictate the type of configuration to be used in SCHF.