Comparative evaluation of result of conservative versus percuteneous K-wire fixation in type III supracondylar fracture humerus in children

Abstract

Background:At present closed reduction and percutaneouspin fixation is most widely accepted treatment method for displaced supracondylar fracture but controversy persists regarding the optimal pinfixation technique.But in Indian continent people not accept operative treatment and no c-arm available everywhere so there is required closed reduction (conservative) management. Method:Total 60 patients selected for the study between the age 3-12years.They were equally allocated to Group-A(percutaneous k-wire fixation)and Group–B (close reduction above elbow stable application).Primary assessment was done for major lossof reductionand iatrogeniculnar nerve injury.Secondary assessment was done for clinical alignment,elbow range of motion,radiographic measurements, Flynn grade, functions and complications. Results: Both groups were evaluated for pre-fracture characteristics and postreduction evaluation at 1st, 2nd, 4th & 6th week, and 3rd & 6th months. No major loss of reductionwas observed in boththegroups,whereas there wasno significant difference between mild lossof reduction,Flynngrade,elbow extension and flexion,carrying angle,total range of motion (p>0.05), but there were 3 ulnar nerve injuries in group A. Conclusion:There was statisticallyno significant difference between 2 groups in termsof stability,duration ofbone healing and loss of reduction butgroupA shows 3 cases of ulnar nerve injuries and in group B shows 3 cases malunion.So,we conclude that percutaneous k-wire fixation is best technique for supracondylar fracture humerus in children but there is chance of iatrogenic ulnar nerve palsy.