Comparison of closed reduction and percutaneous cross verses parallel k wire fixation in supracondylar fractures of the humerus in children.

Abstract

Around the elbow, supracondylar injury of humerus is one of the conventional fractures which usually occurs at the age of 7 to 8 years. Various conservative techniques have been used for the management, which comprises of the splintage, tractions, open or closed reduction with k wire fixation. However, closed reduction and percutaneous pinning remains the mainstay of surgical management, for they have shown splendid outcomes according to many authors. Objectives: The aim of this study is to summarise and compare the radiological and functional results of two ways of fixation (cross and parallel closed K wires) of supracondylar fractures in children. Study Design: Randomized controlled trial. Setting: Department of Orthopaedics Surgery, Services Hospital, Lahore. Period: 1^st January 2018 to 31^st June 2018. Material & Methods: We included 180 patients (90 in each group). Results: The mean age was 6.45±2.34 years with 115(63.9%) male and 65(36.1%) female. Among the children who underwent fixation with cross k-wires, ulnar nerve injury was seen in 2(2.2%) cases and none were seen in the other group post operatively. Group A attained higher union rate at last follow up. 4(4.4%) cases in Cross K-wires and 19(21.1%) in two lateral k-wires gave outstanding outcome. In a nutshell, 60 in group A and 45 in group B showed excellent outcomes based on Flynn's criteria, p-value < 0.05. Conclusion: According to Flynn’s criteria, closed percutaneous cross K-wire fixation of supracondylar fracture of humerus is an effective management option in terms of finer functional results as compared to Parallel k-wires. Although, the rate of radiological union is higher in cross k-wire fixation, there are 2.2% chances of ulnar nerve injury.