Humeral Supracondylar Fractures in Children: A Novel Technique of Lateral External Fixation and Kirschner Wiring
- Author:
Kow RY
;
Zamri AR
;
Ruben JK
;
Jamaluddin S
;
Mohd-Nazir MT
- Publication Type:Journal Article
- Keywords:
Supracondylar fracture;
humerus;
external fixator;
Kirschner wire
- MeSH:
Humeral Fractures
- From:Malaysian Orthopaedic Journal
2016;10(2):41-46
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Supracondylar fracture of the humerus is the
most common fracture around the elbow in children. Pinning
with Kirschner wires (K-wires) after open or closed
reduction is generally accepted as the primary treatment
modality. However, it comes with the risk of persistent
instability and if the K-wire is not inserted properly, it may
cause displacement and varus deformity. We present our
two-year experience with a new technique of lateral external
fixation and K-wiring of the humeral supracondylar fracture.
Materials and Methods: A total of seven children with
irreducible Gartland Type III supracondylar humeral fracture
were treated with closed reduction and lateral external
fixation and lateral Kirschner wiring. Patients with ipsilateral
radial or ulnar fracture, open fracture and presence of
neurovascular impairment pre-operatively were excluded.
All the patients were followed up at one, three and six weeks
and three and six months. The final outcomes were assessed
based on Flynn's criteria.
Results: All the patients achieved satisfactory outcomes in
terms of cosmetic and functional aspects. All patients except
one (85.5%) regained excellent and good cosmetic and
functional status. One patient (14.3%) sustained pin site
infection which resolved with oral antibiotic (CheckettsOtterburn
grade 2). There was no neurological deficit
involving the ulnar nerve and radial nerve.
Conclusion: The introduction of lateral external fixation and
lateral percutaneous pinning provide a promising alternative
method for the treatment of humeral supracondylar fracture.
This study demonstrates that it has satisfactory cosmetic and
functional outcomes with no increased risk of complications
compared to percutaneous pinning.
- Full text:P020160923517335194250.pdf
