A Comparative Study of Functional Outcome of Cross K-wiring V/S Lateral K-wiring in Type III Supracondylar Humerus Fractures in Children
|IJOCP | Volume 2015| Issue – 2015| Article ID – 2015:31
Conference: Poona Orthopaedic Society Annual Conference POSAC-2015, India [Click for Full details]
Authors: Abhijit Gholap , Sanjay Patil, Arvind Bhave
Authors Affiliations: Bharati Hospital & Research Center, Pune
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Background and Objectives: Supracondylar humerus fracture is one of the commonest fractures of upper limb in children. The commonly accepted treatment of type 3 supracondylar humerus fracture in children is closed reduction with percutaneous pinning,although controversy persists regarding the optimal pin-fixation technique. The present study aims at comparing the functional outcome of percutaneous crossed pinning with lateral pinning for the operative treatment of completely displaced supracondylar humerus fractures in children.
Methods: The study was a single centre, prospective, randomized controlled clinical trial in 40 cases.The mean age of patients was 6.75 years with a peak incidence in the age group of 5 – 8 years.All patients had closed fractures without any prior neurological deficit. Mean duration of follow up was 19.53 months. All the percutaneous pinning was done according to a uniform standardized technique.An analysis of result with regards to the ulnar nerve injury, carrying angle and range of motion was made in 20 children with lateral pinning and 20 children with crossed pinning.The primary study end points were a major loss of reduction and iatrogenic ulnar nerve injury. Secondary study end points included radiographic measurements, clinical alignment, range of motion, function, and complications
Results: There was no statistically significant difference with regards to functional outcome and range of motion, between the two groups. Both methods produced satisfactory results in all cases.Pin tract infection (7.5%) and ulnar nerve palsy (2.5%) and loss of reduction (5%) occurred as complications.The average change in carrying angle was 2.5 degrees for crossed pinning and 3.1 degrees for the lateral pinning group. The difference between the two groups was not statistically significant.
Conclusion: Percutaneous pinning is an excellent method in treatment of type 3 supracondylar fractures in children.If a uniform standardized operative technique is followed in each method, then the result of both the percutaneous fixation methods will be same in terms of safety and efficacy. Crossed medial and lateral pinning may beconsidered as the treatment of choice in majority of these fractures, with careful technique safeguarding against ulnar nerve injury.
|How to Cite this Abstract|
|Gholap A, Patil S, Bhave A. A Comparative Study of Functional Outcome of Cross K-wiring V/S Lateral K-wiring in Type III Supracondylar Humerus Fractures in Children. International Journal of Conference Proceedings 2015;(2015):31.|