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Analysis of displaced supracondylar fractures in children treated with closed reduction and percutaneous pinning

Rajarajan Nagu Sakthivel, Vijayan Balakrishnan, Ganesh Vadivelu.

Abstract
Background: Closed reduction is difficult not only to achieve but also to maintain because of the thinness of bone of the distal humerus between the coronoid and olecranon where most supracondylar fractures occurs. For this reason percutaneous pinning techniques have become the treatment of choice for most supracondylar fractures. By this procedure even the displaced and rotated fracture can be treated successfully with minimal incidence of complications. The purpose of this study is to determine the efficacy of management of displaced supracondylar fractures using closed reduction with percutaneous K-wire pinning and to analyze the results, loss of carrying angle, and loss of motion with incidence of complications.
Methods: 35 Cases of displaced supracondylar fractures in children aged between 3 and 13 years were treated by closed reduction and percutaneous pinning and were studied prospectively for functional outcome.30 cases were treated with crossed pinning. 5 cases were treated with lateral pinning.
Results: 31(88.6%) of the patients observed satisfactory results. 4 (11.4%) of the patients observed poor results. Of the cases treated by crossed pinning 26 (86.5%) had good results and 4 (13.3%) had poor results. All the patients treated with lateral pinning had excellent results. The difference in the functional outcome between the two groups were statistically significant.
Conclusion: The results obtained in this study shows that anatomical reduction by closed method and stabilization with K-wire fixation is the first treatment of choice for displaced supracondylar fractures.

Key words: Displaced supracondylar fracture humerus, K-wire, Percutaneous, Closed reduction and internal fixation


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