COMPARISON OF PERCUTANEOUS PINNING WITH CASTING IN SUPRACONDYLAR HUMERAL FRACTURES IN CHILDREN

Mohammad Shoaib Khan, Shahid Sultan, Mian Amjad Ali, Alamzeb Khan, Mohammad Younis

Abstract


Background: In Children Supracondylar fracture of humerus is one of the most common fractures in first decade of life. There are various treatment modalities for this fracture i.e. Close reduction and casting, open reduction and internal fixation, skeletal traction and Percutaneous Pinning. This study was conducted to know the outcome of Percutaneous Pinning in the management of displaced supracondylar humeral fracture in children and to compare the results with close reduction and castings and published literature. Methods:This descriptive study was conducted in Orthopaedic department of Ayub Teaching Hospital Abbottabad and Lady Reading Hospital, Peshawar from January 2002 till December 2003 on 40 children. Patients included were of either gender with age range from 3 to 12 years with displaced supracondylar fracture presenting within 72 hours of injury. Two treatment modalities were studied for comparison. Cross k-wires fixation through each humeral condyle was done after closed reduction of fracture under image intensifier in general anesthesia. Casting/Backslab was applied after reduction of fracture without image intensifier under anesthesia or analgesia. Out come measures were according to Flynn criteria that are functional and cosmetic factor which is based on loss of elbow motion and carrying angle in degrees respectively. Results: Cross percutaneous pinning gave excellent results in 13 (65%), good outcome in 4(20%) and poor outcome in 3(15 %) patients. While patients treated with close reduction and casting showed excellent results in  4 patients (20%), good in 8 patients (40%), fair in 2  patients (10%) and poor in 6  patients (30%). Conclusion: Closed reduction and cross percutaneous pinning for displaced supracondylar humerus fractures in children is safe, cost and time effective method and gives stable fixation with excellent outcome as compared to close reduction and casting.

Keywords: Percutaneous Pinning, Supracondylar fracture, Humerus fractures, close reduction


Full Text:

PDF

References


Eliason EL. Dressing for supracondylar fracture of humerus. JAMA 1924;82:1934-5.

Wilson PD. Fractures and dislocation in the region of elbow. Surg Gynecol Obstet 1933; 56: 335-59.

Henrikson B. Supracondylar fracture of humerus in children. Acta Chir Scand 1966;36:9-12

Abraham E, Powers T-Vitt. Excremental hyper extension of supracondylar fracture in monkeys. Clin Orthop 1982;171:309-18.

Gillingham BL, Rang M. Advances in children elbow fractures (editorial). J Pediatr Orthop 1995;15:419-21.

McIntyre W. Supracondylar fracture of humerus. In: Eltts RM (ed) Management of paediatric fractures. New York: Churchill Livingstone, 1994: 167-91.

Gartland JJ. Management of supracondylar fracture of humerus in children. Surg: Gynecol Obstet 1959;109:145-54.

Cotton FJ. Elbow fractures in children. Ann Surg 1902;35:252-69.

Minkowitz B, Busch MT. Supracondylar fracture of humerus, current trends and controversies. Orthop Clin North Am 1994;25:581-94

Green NE. Overnight delay in the reduction of supracondylar fractures of the humerus in children. J Bone Joint Surg 2001;83: 321-2.

Piron AM, Gronam HK, Kraj Bich JI. Management of displaced extension type of supracondylar fracture of humerus in children. J Bone Joint Surg 1988;70-A: 641-50

Rejholec M. Supracondylar fractures of the humerus in children - closed pinning. Sb Lek 1999;100:279-86.

Mostafavi HR, Spero C. Crossed pin fixation of displaced supracondylar humerus fractures in children. Clin Orthop 2000;376:56-61.

O’Hara LJ, Barlow JW, Clarke NM. Displaced supracondylar fractures of the humerus in children. Audit changes practice. J Bone Joint Surg Br 2000;82:204-10.

Flynn JC, Mattews JG, Beriot RL. BUCD pinning of displaced supracondylar fracture of humerus in children. J Bone Joint Surg 1974:56-A: 263-72.

Cekanauskas E, Degliute R, Kalesinskas RJ. Treatment of supracondylar fracture in children according to Gartland classification. Medicina (Kaunas) 2003;39:379-83.

Celiker O, Pestilci FI, Tuzuner M. Supracondylar fracture of humerus in children: analysis of results in 142 patients. J Orthop trauma 1990;4:265-9.

Ababneh M, Shannak A, Agabi S, Hadadi S. The treatment of displaced supracondylar fractures of the humerus in children. A comparison of three methods. Int Orthop 1998; 22:263-5.

Umar M, D Sousa OP. Supracondylar fracture of humerus in children. An analysis of different treatment modalities at the Agha Khan University Hospital Karachi, Pakistan. Pakistan J Surg 1991;7:16-22.

Din SU, Ahmed I. Percutaneous crossed pin fixation of supracondylar humeral fracture in children J Post grad Med Inst Jun 2003;17(2):184-8.

Diri B, Tomak Y, Karaismailoglu TN. The treatment of displaced fractures of the humerus in children(an evaluation of three different treatment methods).ULUS Trauma Derg 2003;9:62-9.


Refbacks

  • There are currently no refbacks.


Contact Number: +92-992-382571

email: [jamc] [@] [ayubmed.edu.pk]