Preoperative "target marking" on the skin reduces radiation exposure and total surgical duration in surgically treated pediatric supracondylar humerus fractures: a case-control clinical study.

Abstract

Primary treatment for supracondylar humerus fractures (SCHF) involves a closed reduction and fixation with K-wires. The aim of this study is to investigate whether a target marking of the humerus is effective in reducing operation duration and radiation exposure in surgically treated pediatric SCHF. Patients treated with a closed reduction and percutaneous pinning for an SCHF between 2019 and 2023 were included. The study data were categorized into 2 groups: group 1 patients underwent closed reduction, followed by outlining the boundaries of the humerus on the skin and subsequent fixation with K-wires (target marking group), whereas group 2 patients underwent closed reduction without outlining (unmarked group). The same K-wire configuration, consisting of 2 lateral and 1 medial crossed pinning, was used. Operation duration and the radiation dose received (in millisieverts) were recorded for each patient and then compared among them. Overall surgical duration was significantly shorter in group 1 (P < .001). A significantly lower radiation dose was required in patients of group 1 to achieve a satisfactory reduction for both fracture types and for the overall patient cohort (P < .001). Enhancing the 3-dimensional perception of the surgeon in pediatric SCHF treated with closed reduction and percutaneous pinning resulted in a reduction of both the operative duration and the radiation dose. A novel method of "target marking" showed a significant reduction in surgical duration and the amount of radiation exposure.