Is Percutaneous Fixation Necessary & Adequate For Displaced Supracondylar Fractures of Humerus in Children? - An Institutional Study

Abstract

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 in the management of displaced supracondylar humerus fractures in children and to see the associated complications with this method of fixation. Materials & Methods: This retrospective study comprising of 40 cases of displaced supracondylar humerus 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 July 2019 to june2020. The inclusion criteria were: a) Gartland extension type II, III, b) age below 12 years, c) presented to OPD/Emergency within 48 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. Results: Out of the 40 patients, 25 (62.5%) were male and 15(37.5%) were female. The children were aged 2 years to 12 years with a median age of 7.67 years. There were 19 left sided and 21 right-sided fractures. 29 children had an injury while playing and 11 had a fall from a height. functional results in our study were 67.5% of cases had excellent results, 25% had good results, 5% had a fair result and 2.5% had a poor result. 75% of cases had excellent cosmetic results were 17.5% of cases had good results, 5% had fair result and only one case had a poor 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