Outcome of early versus delayed Kirschner wire fixation of supracondylar fractures of humerus in children

Author(s): Rijal Raju, Chaudhary Atulya, Choudhary Pashupati, Maharjan Rajiv, Khanal Guru Prasad, Kalawar Rosan Prasad Sah and Rai Pramila

Abstract: Purpose: Controversy still persists regarding optimum intervention time for late presentations of supracondylar fracture of humerus in children. We compared outcomes in early and late groups of presentation and management.
Study design: We conducted prospective study comparing early and late open reduction and Kirschner wire fixation for Gartland type III supracondylar fracture of humerus in children aged less than 16 years. We analyzed results of 27 cases in early group and 19(8 lost) cases in late group. We compared duration of surgery, range of motion, and Flynn’s criteria were used to evaluate outcome.
Results: Thirty (65%) patients were male and 15(32.60%) had dominant limb involvement. Injury to surgery time was 53.63±41.03 hours in early group and 338.53±134.31 hours in late group (p<0.005). Pre-operative nerve injury was 6(13%) cases in early group. Bauman’s angle at 12 weeks in early group was 70.04± 3.240 & in late group had71.42± 8.329. (p< 0.513). Loss of range of motion between groups was insignificant (p< 0.668). According to Flynn’s, results were comparable between groups.
Conclusion: We concludes that in cases of Garland type III supracondylar fracture of humerus of children open reduction & k-wire fixation is an effective method of treatment in both groups.

DOI: https://doi.org/10.22271/ortho.2017.v3.i4g.61