A Study of Management of Supracondylar Fracture of Humerus in Paediatric Age Group by Open and Closed Reduction with Internal Fixation


K. Chandra Sekhar Rao1 , V. Shivram Naik2 , P. Rajesh3

BACKGROUND Supracondylar humerus fracture is the most serious paediatric skeletal injury of elbow in children. Supracondylar fracture of humerus leads to many complications due to the intrinsic fracture instability, close proximity of the brachial artery, three main upper extremity nerves, poor radiographs, contradictory perception of reduction and reduction management modalities and, lastly, patient compliance with care. The aim of this research is to determine the short-term outcomes of closed and open reduction and Kirschner wire fixation in childhood Gartland type III supracondylar humerus fracture. METHODS It is a comparative case series of 2 years duration conducted among 30 patients with supracondylar humerus fracture who were admitted and treated at the Department of Orthopaedics. Closed reduction was handled in 15 out of 30 patients, with the remaining 15 patients being treated by open reduction. The outcomes are calculated on the basis of the Flynn scale, which is based on change in the carrying angle and loss of motion after treatment. RESULTS Males (56.66 %) were more affected than females; left side (66.67 %) was more affected than the right side; fractures of type III were more common. 26 patients stayed in a sufficient range of motion, 4 patients had insufficient motion with a loss of more than 100, of which 3 were treated with a closed reduction and 1 with an open reduction. Twenty-six (86.66 %) of the 30 patients showed good to excellent results and four (13.33 %) showed mediocre to poor results. Of the four cases, one was handled with a closed reduction and three were handled with an open reduction. CONCLUSIONS We conclude that open reduction and K-wire fastening without triceps is a treatment option for displaced supracondylar humerus fractures.