FUNCTIONAL OUTCOME OF PERCUTANEOUS TRANSOLECRANON AND LATERAL KIRSCHNER WIRE FIXATION FOR DISPLACED SUPRACONDYLAR FRACTURE OF HUMERUS IN CHILDREN

Abstract

Background: Supracondylar fracture of the humerus is one of the most common fracture occurring in children. When the patients present with swelling of the elbow, there is a dilemma whether to wait for the swelling to subside or to perform closed reduction and percutaneous pinning immediately. The objective of this study was to assess the functional outcome of percutaneous transolecranon and lateral K wire fixation and to observe the outcomes associated with this K wire configuration.

Methods: This was a prospective observational study done between 2021 and 2022 at Chitwan Medical College, Nepal. The study included 40 children with closed Gartland type II and III supracondylar fracture of the humerus with no neurovascular injury. They were treated within 3 days with closed reduction and percutaneous pinning using the transolecranon and lateral K-wire fixation technique. The outcome was assessed using the Flynn’s elbow Grading criteria.

Results: At 12 week follow up, 7 (17.5 %) patients had excellent result, 21 (52.5%) patients had good, 8 (20%) patients had fair and 4 (10%) patients had poor result. According to Flynn’s grading system 90 % had satisfactory result and 10 % had unsatisfactory result. Four patients had loss of reduction out of which 2 had poor result and 2 had fair result. None of the patients had post operative iatrogenic ulnar nerve injury.

Conclusions: The percutaneous transolecranon and lateral K-wire fixation for displaced supracondylar fracture of the humerus in children is a good treatment option when the elbow is swollen and is reliable as it prevents iatrogenic ulnar nerve injury.