A comparison between percutaneous cross k wire and lateral k wires fixation in management of Type III Gartland paediatric supracondylar fractures

Author(s): Nikhil D Palange, Dr. Prasannakumar GS, Dr. Akash Mane and Dr. Eknath Pawar

Abstract: Introduction: Supracondylar humerus fractures are one of the commonest fractures in the paediatric age group. Displaced fractures of these kind, that is, Gartland type III are treated by closed or open reduction and k wire fixation. Cross k wire and lateral wires are the commonest configurations used for fixation. The present study aims to evaluate the difference between the two configurations in terms of surgical technique, functional outcome and complications. Materials and methods: A prospective study of 30 paediatric patients with displaced Supracondylar humerus fractures was carried out between September 2016 to September 2017. 15 patients were treated with cross k wire fixation (Group A) while the rest with 2 lateral k wires (Group B). The functional outcome of the 2 groups was measured by Flynn’s criteria. Also, the intra operative difficulties and iatrogenic ulnar nerve palsy were noted. Statistical analysis between the two groups was done by Student’s t-test to find any statistical significant difference. Results: As per Flynn’s criteria, 66.67 % patients treated with cross k wire fixation and 60.00 % patients treated with lateral k wires had excellent functional outcome. This difference was not statistically significant. 3 patients in group A had ulnar nerve palsy which resolved within 3 weeks after surgery. No incidence of ulnar nerve palsy was found in patients of group B. Conclusions: There is no statistical difference between the two techniques with respect to functional outcome indicating that both methods are equally efficient. However, there is a risk of ulnar nerve palsy during insertion of the medial wire of the cross k wire fixation.

DOI: https://doi.org/10.22271/ortho.2019.v5.i2c.22