Abstract: Background: Displaced supracondylar fracture of humerus is a common orthopaedics problem in children. The most common complications associated with these fractures are mal-union leading to cubitus varus, stiffness of elbow, myositis ossificans, compartment syndrome and neurovascular deficit. Different methods have been described for its management of which closed reduction and percutaneous pinning with K-wires has been preferred treatment with satisfactory results.
Material and Methods: Between March 2017 to May 2018, 36 patients with supracondylar fracture of humerus of Gartland type II & III in children were included in this study. These patients were treated by closed reduction of fracture and percutaneous fixation with K-wire under C-arm guidance. The functional outcome was assed clinically by Flynn’s criteria. The assimilated data was analyzed using various statistical methods like descriptive statistics (mean, standard deviation, standard error), chi-square test. Estimates of population proportions were obtained using estimator sample proportions and 95% confidence intervals under standard normal distribution approximation for large sample.
Results: In our study, the mean age of the patients was found to be 6.64 years with male preponderance (72.22%) as compared to females (27.78%). Statistical analysis (test statistic; Fisher Exact test for count data – two sided) on the observations of Flynn’s grading score for different fixation methods viz. 2 Cross-wire (2C), 2 Lateral (2L) and 3K-wire depicted that proportions of satisfactory grading in all fixation methods (2C, 2L and 3K) are same (p-value 1.00) and hence results found no significant difference between fixation methods and Flynn’s grading score. This study revealed that the mean hospital length of stay for 2C and 3K fixation methods was 2.11± 0.29 and 2.33 ± 0.35 (p-0.609) respectively. The satisfactory result for loss of carrying angle and loss of range of motion was 94.44% and 100% for 2C and 3K fixation methods respectively.
Conclusions: The results of our study demonstrated that closed reduction and percutaneous fixation using K-wire of displaced supracondylar fractures of humerus in children would be the simple, cheap, safe and effective method of treatment with relatively fewer complications and reduced hospital stay.
