Comparative Evaluation of Results Between Medial and Lateral Cross Pins Method and 2 Lateral Pins Method for Closed Reduction and Percutaneous K-wire Fixation in Pediatric Supracondylar Fracture Humerus (Pilot Study)

Abstract

Introduction: Closed reduction and percutaneous K-wire fixation is the standard treatment of displaced supracondylar fractures of the humerus in children. Controversies exist about the optimal K-wire configuration in displaced Type II and III fracture. Purpose: The aim of the study is to compare the results of crossed k-wire fixation and lateral wire fixation techniques from the point of stability of reduction and complications rate. Methods: The study was done on 20 children with displaced supracondylar humerus fracture. The inclusion criteria are displaced fracture (Gartland Type II and III), extension type only without any neurological deficits. We exclude open fractures, flexion type fractures and any neurological insult at time of presentation. Every patient was followed up for a period of 4 months. Results: Among the 20 patients, 12 patients were treated with crossed pinning technique and 8 patients were treated with lateral pinning technique. From the 12 patients treated with crossed pinning 2 developed iatrogenic ulnar nerve injury and from the 8 patients treated with lateral pinning technique 2 had loss of fixation stability and needs fracture re-reduction and fixation. Conclusion: Closed reduction and percutaneous pinning is the preferred surgical technique used for treatment of displaced supracondylar fracture of the humerus in children. Lateral wires technique seems to achieve less fracture stability. However, the use of two lateral wires or three lateral wires that are in divergent