Minimally Invasive-Closed Reduction and Percutaneous Pinning for Supracondylar Fractures of the Humerus in Children

Nabees Man Singh Pradhan, Rojan Tamrakar, Bidur Gyawali, Toya Raj Bhatta, Balakrishnan M Acharya, Suman Shrestha, Saroj Krishna Shrestha, Achyut Rajbhandari, Utsab Shrestha

Abstract


Introductions: Although Closed Reduction and Percutaneous Pinning is the gold
standard of treatment for Supracondylar fractures (SC) in children, reduction
is not always easy. Minimally Invasive, Closed Reduction and Percutaneous
Pinning (MI-CRPP) reduces the soft tissue trauma and provides easy reduction.
We have reviewed the success rate of minimally invasive reduction technique
and its outcome.


Methods: We reviewed the charts of 155 children (97 male, 58 female) age
ranging from 2 to 14 years with SC fractures of the humerus who were operated
with minimally invasive closed reduction and precutaneous pinning from
November 2008 to June 2014 at Patan Hospital and Om Hospital. They were
followed up for a mean of eight (4 to 24) weeks. The K-wires were removed at
4 to 6 (average 4.28) weeks.


Results: Male children were affected more than female with the ratio being 97
to 58. Right side was affected more than left (ratio 89 to 66). Post-operatively,
there were six (3.87%) ulnar nerve injury and eight (5.16%) patients came with
superficial pin tract infection. One hundred and thirteen (72.9%) had excellent,
35 (22.58%) good, five (3.23%) fair and two (1.3%) poor results at the eight
week follow-up which was improved to 144 (92.9%) excellent, seven (4.5%)
good, three (1.9%) fair and one (0.65%) poor results at the 14 week follow-up.

Conclusions: Closed reduction of supracondylar fractures of the humerus in
children with minimally invasive technique prior to K-wire fixation is a relatively
simple, safe and effective method of achieving satisfactory reduction and good
functional outcome.


Keywords: cubitus varus deformity, K wire fixation,minimally invasive closed
reduction and precutaneous pinning, supracondylar fractures


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