DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20190797

Analysis of clinicoradiological parameters following fixation of paediatric supracondylar humerus fractures with three lateral pins

Saurabh Daga, Pushpal Sarkar, Paras Kumar Banka

Abstract


Background: Supracondylar humerus fractures are one of the commonest fractures encountered in children. This fracture has been managed both conservatively with a long arm plaster and operatively by fixing with Kirschner wires. Debate still remains regarding the pin configuration to be used for fracture stabilisation. This study analyses the clinical and radiological parameters following fixation of supracondylar humerus fractures in paediatric patients with three lateral pins.

Methods: It is a prospective study with 30 patients conducted between April 2016 and September 2016 conducted in Medical College and Hospital, Kolkata. All the said patients underwent closed reduction and percutaneous pinning with three laterally placed divergent kirschner wires.

Results: Most of the patients in this study had clinicoradiological parameters well within normal limits, barring a few. The baumann’s angle was well within normal limits in these cases as found in subsequent follow-ups.

Conclusions: In this study, it was found that lateral pinning can be safely employed for fixing supracondylar humerus fractures in children with lesser chances of iatrogenic ulnar nerve palsy which was encountered with crossed pin configuration.

 


Keywords


Supracondylar humerus, Kirschner wire, Baumann’s angle

Full Text:

PDF

References


Gordon JE, Patton CM, Luhmann SJ, Bassett GS, Schoenecker PL. Fracture stability after pinning of displaced supracondylar distal humerus fractures in children. J Pediatr Orthop. 2001;21(3):313-8.

Skaggs DL, Hale JM, Bassett J, Kaminsky C, Kay RM, Tolo VT .Operative treatment of supracondylar fractures of the humerus in children. The consequences of pin placement. J Bone Joint Surg Am. 2001;83(5):735-40.

Lee YH, Lee SK, Kim BS, Chung MS, Baek GH, Gong HS, Lee JK. Three lateral divergent or parallel pin fixations for the treatment of displaced supracondylar humerus fractures in children. J Pediatr Orthop. 2008;28(4):417-22.

Foead A, Penafort R, Saw A, Sengupta S. Comparison of two methods of percutaneous pin fixation in displaced supracondylar fractures of the humerus in children. J Orthop Surg. 2004;12(1):76-82.

Brauer CA, Lee BM, Bae DS, Waters PM, Kocher MS. A systematic review of medial and lateral entry pinning versus lateral entry pinning for supracondylar fractures of the humerus. J Pediatr Orthop. 2007;27(2):181-6.

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.

Flynn JC, Matthews 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.

Gaston RG, Cates TB, Devito D, Schmitz M, Schrader T, Busch M, et al. Medial and lateral pin versus lateral-entry pin fixation for Type 3 supracondylar fractures in children: a prospective, surgeon-randomized study. J Pediatr Orthop. 2010;30(8):799-806.

Hamdi A, Poitras P, Louati H, Dagenais S, Masquijo JJ, Kontio K. Biomechanical analysis of lateral pin placements for pediatric supracondylar humerus fractures. J Pediatr Orthop. 2010;30(2):135-9.

Karapinar L, Ozturk H, Altay T, Kose B. Closed reduction and percutaneous pinning with three Kirschner wires in children with type III displaced supracondylar fractures of the humerus. Acta Orthop Traumatol Turc. 2005;39(1):23-9.

Lee KM, Chung CY, Gwon DK, Sung KH, Kim TW, Choi IH, et al. Medial and lateral crossed pinning versus lateral pinning for supracondylar fractures of the humerus in children: decision analysis. J Pediatr Orthop. 2012;32(2):131-8.

Maity A, Saha D, Roy DS. A prospective randomised, controlled clinical trial comparing medial and lateral entry pinning with lateral entry pinning for percutaneous fixation of displaced extension type supracondylar fractures of the humerus in children. J Orthop Surg Res. 2012;7:6.

Mazda K, Boggione C, Fitoussi F, Pennecot GF. Systematic pinning of displaced extension-type supracondylar fractures of the humerus in children. A prospective study of 116 consecutive patients. J Bone Joint Surg Br. 2001;83(6):888-93.

Prashant K, Lakhotia D, Bhattacharya TD, Mahanta AK, Ravoof A. A comparative study of two percutaneous pinning techniques (lateral vs medial-lateral) for Gartland type III pediatric supracondylar fracture of the humerus. J Orthop Traumatol. 2016;17(3):223-9.

Sahu RL. Percutaneous K-wire fixation in paediatric Supracondylar fractures of humerus: A retrospective study. Niger Med J. 2013;54(5):329-34.

Sangkomkamhang T, Singjam U, Leeprakobboon D. Risk factors for loss of fixation in pediatric supracondylar humeral fractures. J Med Assoc Thai. 2014;97(9):S23-8.

Shamsuddin SA, Penafort R, Sharaf L. Crossed-pin versus lateral-pin fixation in pediatric supracondylar fractures. Med J Malaysia. 2001;56:38-44.

Shannon FJ, Mohan P, Chacko J, D’Souza LG. Dorgan's percutaneous lateral cross-wiring of supracondylar fractures of the humerus in children. J Pediatr Orthop. 2004;24(4):376-9.

Solak S, Aydin E. Comparison of two percutaneous pinning methods for the treatment of the pediatric type III supracondylar humerus fractures. J Pediatr Orthop B. 2003;12(5):346-9.

Woratanarat P, Angsanuntsukh C, Rattanasiri S, Attia J, Woratanarat T, Thakkinstian A. Meta-analysis of pinning in supracondylar fracture of the humerus in children. J Orthop Trauma. 2012;26(1):48-53.

Yen YM, Kocher MS. Lateral entry compared with medial and lateral entry pin fixation for completely displaced supracondylar humeral fractures in children. Surgical technique. J Bone Joint Surg Am. 2008;90(2):20-30.

Zamzam MM, Bakarman KA. Treatment of displaced supracondylar humeral fractures among children: crossed versus lateral pinning. Injury. 2009;40(6):625-30.

Zhao JG, Wang J, Zhang P. Is lateral pin fixation for displaced supracondylar fractures of the humerus better than crossed pins in children?. Clin Orthop Relat Res. 2013;471(9):2942-53.