Vol. 11, Issue 3 (2025)

Background: Supracondylar humeral fractures are the most common pediatric elbow injuries, with Gartland Type III fractures being the most severe and often requiring surgical fixation. While crossed pinning offers superior stability, it carries a risk of ulnar nerve injury, prompting increased use of lateral-entry techniques. Recently, minimally invasive intramedullary K-wire fixation has emerged as a promising method that ensures stable fixation with reduced soft tissue trauma and radiation exposure.
Aim of the study: This study evaluates the functional outcomes, complication rates, and radiation exposure associated with minimally invasive intramedullary K-wire fixation in pediatric patients with Gartland Type III supracondylar fractures.
Methods: This retrospective observational study was conducted at the Department of Orthopaedic Surgery (Hand and Microsurgery), National Institute of Traumatology & Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh and included 60 children (ages 4-12) with Gartland Type III supracondylar humerus fractures. The study duration was 12 months from January to December 2021. Patients underwent minimally invasive percutaneous intramedullary K-wire fixation under general anesthesia. Radiation exposure, operative time, and intraoperative fluoroscopy details were recorded. Postoperative care included splinting, early mobilization, and follow-up at 2, 6, and 12 weeks. Clinical outcomes were assessed using VAS, elbow ROM, Flynn’s criteria, and radiographs. Data were analyzed using SPSS v26.0. Primary outcomes included radiation exposure and functional results; secondary outcomes included pain, union time, complications, and hospital stay.
Results: Out of 60 children with Gartland Type III supracondylar humeral fractures, the mean age was 7.1 years, with 73.3% males and 63.3% left-sided injuries. Falls were the predominant cause (88.3%). The average operative time was 45.2 minutes, with a low mean fluoroscopy time of 13.9 seconds. No intraoperative complications occurred. Radiographic union was achieved in 5.1 weeks, with only 3.3% developing superficial infections. At 6 weeks, 93.3% showed excellent to good outcomes according to Flynn’s criteria, and all patients regained full range of motion within 3 months. Functional recovery and complication rates were highly favorable.
Conclusion: Minimally invasive intramedullary K-wire fixation is a safe, effective, and low-radiation technique for treating Gartland Type III supracondylar fractures in children. It ensures stable fixation, minimal complications, and rapid recovery, making it ideal for resource-limited settings like Bangladesh.