Treatment of supra condylar fractures of humerus in children, a SKIMS medical college study
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20203720Keywords:
Closed reduction, Fractures, Humerus, Kirschner wire, Supra condylar, Volkman’s ischaemic contractureAbstract
Background: Supracondylar fractures of the humerus account for sixty percent of all fractures around the elbow in children. Delayed presentation of these fractures is very common even in developed countries. The aim of the present study was to evaluate the clinical, radiological and functional results following closed reduction (C/R) and percutaneous pinning of widely displaced supracondylar fractures of humerus. An objective of this study was to study supracondylar fractures of humerus in children in Skims medical College.
Methods: A total 86 patients with displaced extension type supracondylar fractures (gartland type III) of humerus were managed by closed reduction and percutaneous fixation at Skims medical college after achieving optimal and satisfactory reduction. There were 52 boys and 28 girls. Average age was 6.69 years (range 2-12).
Results: A total 86 patients were successfully treated with C/R and cross pinning. 6 patients were lost to follow-up. 80 patients with a minimum follow-up period of 12 months formed the basis of this study.
Conclusions: C/R and pinning is effective method despite delayed presentation. Strict anatomical reduction and stable fixation minimises the risk of developing cubitus varus deformity.
References
Saroff DA. Time to treatment: the question of beneficial surgical delays’. Bone Joint Surge Am. 2001;83(11):1755-6.
Jones KG. Percutaneous pin fixation of fractures of the lower end of the humerus. Clin Orthop Relat Res. 1967;50:53-69.
Swenson AL. The treatment of supracondylar fractures of the humerus by kirschner wire transfixion. J Bone Joint Surg Am. 1948;30(4):993-7.
D’Ambrosia RD. Supracondylar fractures of humerus-prevention of Cubitus varus. J Bone Joint Surg Am. 1972;54(1):60-6.
Dunlop J. Transcondylar fractures of the humerus in childhood. J Bone Joint Surg Am. 1939;21(1):59-73.
Gupta N, Kay RM, Leitch K, Femino JD, Tolo VT, Skaggs DL. Effect of surgical delay on perioperative complications and need for open reduction in supracondylar humerus fractures in children. J Pediatr Orthop. 2004;24(3):245-8.
Ong TG, Low BY. Supracondylar humeral fractures- a review of the outcome of treatment. Singapore Med J. 1996;37(5):508-11.
Palmer EE, Niemann KM, Vesely D, Armstrong JH. Supracondylar fracture of the humerus in children.J Bone Joint Surg Am. 1978;60(5):653-6.
Royce RO, Dulkowsky JP, Kasser JR, Rand FR. Neurologic complications after K-wire fixation of supracondylar humerus fractures in children. J Pediatr Orthop. 1991;11(2):191-4.
Alcott WH, Bowden BW, Miler PR. Displaced supracondylar fracturs of humerus in children: long-term follow-up of 69 patients. J Am Osteopath Assoc. 1977;76(12):910-5.
Harris IE. Supracondylar fractures of the humerus in children. Orthopedics. 1992;15(7):811-7.
Jacob RL. Supracondylar fracture of the humerus in children. IMJ IIIMed J. 1967;132(5):696-701.
Paradis G, Lavallee P, Gagnon N. Supracondylar fractures of humerus in children. Technique and results of crossed percutaneous K-wire fixation. Clin Orthop Relat Res. 1993;297:231-7.
Iyengar SR, Hoffinger SA, Townsend DR. Early versus delayed reduction and pinning of type III displaced supracondylar fractures of the humerus in children: a comparative study. J Orthop Trauma. 1999;13(1):51-5.
Leet AI, Frisancho J, Ebramzadeh E. Delayed treatment of type 3 supracondylar humerus fractures in children. J Pediatr Orthop. 2002;22(2):203-7.
Mehlmann CT, Strub WM, Roy DR. The effect of surgical timing on the perioperative complications of treatment of supracondylar humeral fractures in children. J Bone Joint Surg Am. 2001;83(3):323-7.
Gartland JJ. Management of supracondylar fractures of the humerus in children. Surg Gynecol Obstet. 1959;109(2):145-54.
Wilkins KE. The management of severely displaced supra-condylar fractures of the humerus. Tech Orthop. 1989;4(3):5-24.
Green DW, Widmann RF, Frank JS, Gardner MJ. Low incidence of ulnar nerve injury with crossed pin placement for pediatric supracondylar humerus fractures using a mini-open technique. J Orthop Trauma. 2005;19(3):158-63.
Flynn JC, Mathews JG, Benoit RL. Blind pinning of displaced supracondylar fractures of the humerus in children: sixteen years’ experience with long term follow-up. J Bone Joint Surg Am. 1974;56(2):263-72.
Aronson DD, Prager BI. Spracondylar fractures of the humerus in children. A modified technique for closed pinning. Clin Orthop Relat Res. 1987;(219):174-84.
Cramer KE, Devito DP, Green NE. Comparison of closed reduction and percutaneous pinning versus open reduction and percutaneous pinning in displaced supracondylar fractures of the humerus in children. J Orthop Trauma. 1992;6(4):407-12.
Kumar R, Kiran EK, Malhotra R, Bhan S. Surgical management of the severely displaced supracondylar fracture of the humerus in children. Injury. 2002;33(6):517-22.
Minkowitz B, Busch MT. Supracondylar humerus fractures. Current trends and controversies. Orthop Clin North Am. 1994;25(4):581-94.
Segal D. Pediatric orthopaedic emergencies. Pediatr Clin North Am. 1979;26(4):793-802.
Hart GM, Wilson DW, Arden GP. The operative management of the difficult supracondylar fracture of the humerus in the child. Injury. 1977;9(1):30-4.
Mehlman CT, Crawford AH, McMillion TL, Roy DR. Operative treatment of supracondylar fractures of the humerus in children: the cincinnati experience. Acta Orthop Belg. 1996;62 Suppl 1:41-50.
Peters CL, Scott SM, Stevens PM. Closed reduction and percutaneous pinning of displaced supracondylar humerus fractures in children: description of a new closed reduction technique for fractures with brachialis muscle entrapment. J Orthop Trauma. 1995;9(5):430-4.
Archibeck MJ, Scott SM, Peters CL. Brachialis muscle entrapment in displaced supracondylar humerus fractures: a technique of closed reduction and report of initial results. J Pediatr Orthop. 1997;17(3):298-302.
Boyd DW, Aronson DD. Supracondylar fractures of the humerus: a prospective study of percutaneous pinning. J Pediatr Orthop. 1992;12(6):789-94.
Cheng JC, Lam TP, Shen WY. Closed reduction and percutaneous pinning for type III displaced supracondylar fractures of the humerus in children. J Orthop Trauma. 1995:9(6):511-5.
Prietto CA. Supracondylar fractures of the humerus. A comparative study of Dunlop’s traction versus percutaneous pinning. J Bone Joint Surg Am. 1979:61(3):425-8.
Rasool MN. Ulnar nerve injury after K-wire fixation of supracondylar humerus fractures in children. J Pediatr Orthop. 1998;18(5):686-90.
Gruber MA, Hudson OC. Supraconylar fractures of humerus in childhood. End-result study of open reduction. J Bone Joint Surg Am. 1964;46:1245-2.
Labelle H, Bunnell WP, Duhaime M, Poitras B. Cubitus varus deformity following supracondylar fractures of the humerus in children. J Pediatr Orthop. 1982;2(5):539-46.
Kallio PE, Foster BK, Paterson DC. Difficult supracondylar elbow fractures in children: analysis of percutaneous pinning technique. J Pediatr Orthop. 1992;12(1):11-5.
Sutton WR, Greene WB, Georgopoulos GA, Dameron JT. Displaced supracondylar humeral fractures in children. a comparision of results and costs in patients in patients treated by skeletal traction versus percutaneous pinning. Clin Orthop Relat Res. 1992;(278):81-7.
Davis RT, Gorczyca JT, Pugh K. Supracondylar humerus fractures in children. Comparison of operative treatment methods. Clin Orthop Relat Res. 2000;(376):49-55.
Haddad RJ, Saer JK, Riordan DC. Percutaneous pinning of displaced supracondylar fractures of elbow in children. Clin Orthop Relat Res. 1970;71:112-7.
Nacht JL, Ecker ML, Chung SM, Lotke PA, Das M. Supracondylar fractures of the humerus in children treated by closed reduction and percutaneous pinning. Clin Orthop Relat Res. 1983;177:203-9.