[Closed reduction and percutaneous lateral pin fixation in the treatment of displaced supracondylar fractures of the humerus in children].

Abstract

We evaluated the results of closed reduction and percutaneous lateral-pin fixation in the treatment of displaced supracondylar fractures of the humerus in children. Thirty-four children (25 boys, 9 girls; mean age 7.2 years; range 3 to 13 years) were treated for displaced supracondylar fractures of the humerus. Five patients had Gartland type 2, and 29 patients had type 3 fractures. After closed reduction, lateral-pin fixation was performed with two parallel (n=11) or crossed (n=23) K-wires. Three K-wires were used in five patients. The mean duration of fixation was 3.8 weeks (range 3 to 6 weeks). For comparison with the normal side, the Baumann and carrying angles were measured on anteroposterior, and the humerocapitellar angle on lateral radiographs. The range of motion of the elbow was assessed clinically. The results were evaluated according to the criteria of Flynn et al. after a mean follow-up of 22.6 months (range 10 to 48 months). Union was achieved in all the patients. Complications such as pin-tract infections, myositis ossificans, compartment syndrome, or nerve injuries did not occur. According to the criteria of Flynn et al., functional and radiographic results were satisfactory in all the patients (100%) and in 33 patients (97.1%), respectively. One patient developed cubitus varus of 14 degrees. No significant differences were found between the mean Baumann, humerocapitellar, and carrying angles of the normal and affected sides (p>0.05). Closed reduction and percutaneous lateral pinning proved an efficient, reliable, and safe method in the treatment of displaced supracondylar fractures of the humerus in children.