Comparison of outcome with medial versus lateral approach for operative fixation of superacondylar humeral fractures in paediatric patients.

  • Kashif Siddiq Civil Hospital Bahawalpur/ Quaid-e-Azam Medical College, Bahawalpur.
  • Asad ullah Mehmood Govt Town Hospital Shah Rukne Alam S Block Multan.
  • Muhammad Hamayun Hameed Bolan Medical Complex Hospital Quetta.
  • Muhammad Khalid Chishti Nishtar Hospital Multan/ Nishtar Medical University, Multan.
  • Muhammad Nasir Ali Civil Hospital Bahawalpur/ Quaid-e-Azam Medical College, Bahawalpur.
  • Nazar Hussain BVH/QAMC Bahawalpur.
Keywords: Children, Gartland, Supracondyler Fracture Humerus

Abstract

Objectives: To compare the outcome in terms of carrying angle with medial versus lateral approach in the treatment of these fractures among children. Study Design: Randomized Clinical trial. Setting: Department of Orthopaedic Surgery Civil Hospital Bahawalpur and Nishtar Hospital Multan. Period: From June 2018 to September 2019. Material & Methods: A total of 154 children of both genders, aged 2-14 years having supracondylar humeral fracture of type II and III, with duration of fracture within 7 days, were enrolled. Patients were divided in two groups (77 in each group), group A and group B. Group A was managed by open reduction internal fixation (ORIF) with cross K-wire through medial approach and group B underwent lateral approach. Results: Out of 154 cases, 102 (66.2%) were boys and 52 (33.8%) were girls. Overall, mean age was noted to be 7.98 ± 2.23 years. Obesity was present in 16 (10.4%) cases. Mean duration of fracture was noted to be 4.21 ± 1.34 days while 106 (68.8%) had duration less than 5 days. There were 119 (77.3%) cases with history of fall and 35 (22.7%) had history of road traffic accidents (RTA). Sixty one (39.6 %) cases were classified as Gartland type II fractures while remaining 93 (60.4 %) were type III fractures. Excellent outcome with carrying angle 0–5o in group A was noted to be 67 (87 %) while that of group B was 54 (70.1%) (p = 0.011). Conclusion: Medial approach for the treatment of pediatric SHF was noted to be superior in terms of postoperative carrying angle having satisfactory outcome in comparison with the lateral approach.

Author Biographies

Kashif Siddiq, Civil Hospital Bahawalpur/ Quaid-e-Azam Medical College, Bahawalpur.

FCPS

Senior Registrar of Orthopedic Surgery

Asad ullah Mehmood, Govt Town Hospital Shah Rukne Alam S Block Multan.

FCPS

Medical Officer

Muhammad Hamayun Hameed, Bolan Medical Complex Hospital Quetta.

FCPS

Senior Registrar

Muhammad Khalid Chishti, Nishtar Hospital Multan/ Nishtar Medical University, Multan.

FCPS

Assistant Professor of Orthopedic Surgery

 

Muhammad Nasir Ali, Civil Hospital Bahawalpur/ Quaid-e-Azam Medical College, Bahawalpur.

FCPS

Professor of Orthopedic Surgery

 

Nazar Hussain, BVH/QAMC Bahawalpur.

FCPS

Senior Registrar

Published
2020-10-10