Displaced supracondylar fractures of the humerus in children : Delayed closed reduction and percutaneous pinning with two lateral and one medial crossed k-wires.

Abstract

Objective : To evaluate the results of a consecutive group of displaced supracondylar fractures of the humerus in chlidren underwent delayed closed reduction with percutaneous pinning by using two lateral and one medial crossed K-wires.

Methods : Prospective study of 14 children who came to Uthaithanee hospital between January 2002 and April 2004 was performed. All patients arrived after the official hours. They were initial treated by immediate closed reduction with posterior plaster splint and underwent closed reduction with percutaneous pinning within the official hours in the following day by using two lateral pins first and adding one medial crossed pin without hyperflexion of the elbow.

Results : The average time from injury to operation was 29 hours and 16 minutes. The difference in Baumann angle measured in affected elbow comparing to normal site of the same patient were less than 5 degrees ( range 0-4 degrees ).There were 2 cases of complication, one pin tract infection and another iatrogenic ulnar nerve injury those were resolved in one week and 4.5 months
respectively.

Conclusions : Delayed closed reduction with percutaneous pinning by using two lateral and one medial crossed K-wires may be the alternative treatment when the situation is not suitable for emergent surgery.