Open versus closed reduction and K-wire fixation for supracondylar fracture of the humerus (Gartland type 3) in children

Abstract

Background: The purpose of the study was to compare the presentation and postoperative resultsof children treated by open reduction and closed reduction for completely displaced Gartland type IIIsupracondylar humerus fractures (SCFs). Method: Supracondylar fracture of the humerus is acommon paediatric fracture seen in our OPD. Among them Type III fractures are displaced with nocortical contact, and reduction is difficult, and maintaining reduction is almost impossible withoutsome form of internal fixation. Therefore during surgery of type 3 fractures, fixation is done by twomethods. 1 open reduction and fixation with 2 cross k-wire 2. closed reduction and fixation with 2cross k-wire fixation. Following pinning, the elbow was immobilized in an above elbow slab inpronation with the elbow at 75 degrees of flexion. Result: The average age of patients was 5 years(age range, 3 to 10 years). The test population consisted of 18female (36%) and 32 male (64%)patients. There were 31 fractures (62%) in the right elbow and 19 fractures (38%) in the left. Group1 patients stayed in the hospital for 5 days while Group 2 stayed for only 2 days in the hospital. Alsogroup 1 patient required follow-up at eight postoperative days (for check dressing) and 11postoperative days for stitch removal while group 2 patients were directly called for k-wire removalat 3 weeks postoperatively. Both groups of patients were called after three weeks for k-wireremoval. Mean clinical follow-up for both groups was 6 months. Conclusion: The closed reductiontechnique was preferred because it required less hospitalization time, less number followup, andresulted in almost no visible surgical scars.