CLOSED REDUCTION AND PERCUTANEOUS PINNING OF GARTLAND TYPE II AND TYPE III SUPRACONDYLAR FRACTURES OF HUMERUS IN CHILDREN

Abstract

Shyamprasad Polisetty, Manikumar C. J

BACKGROUND Supracondylar fractures of humerus in children are common injuries next only to clavicle and both bone forearm fracture in paediatric age group. They have a male predominance accounting for 16% of all paediatric fractures and 60% of all paediatric elbow fractures. They classically occur as a result of fall on an outstretched hand. There is no controversy regarding management of undisplaced fractures. The treatment modalities of partially displaced and completely displaced fractures are many. Recurrence of displacement occurs in spite of accurate closed reduction and immobilization in flexion. The difficulty in adequately stabilizing a closed reduction without resorting to the extremes of positioning has led to the development of internal stabilization procedures. In literature the most notable evolution in the management of elbow injuries has been an increasing emphasis on early motion. MATERIALS AND METHODS Thirty five children who suffered either Gartland type II or type III supracondylar fractures were included in the study. All of them were treated with closed reduction and percutaneous pinning under C arm control. The study period spanned January 2016 to January 2017. All the patients were subjected to general anaesthesia. Common postoperative protocol was followed. The study was conducted at the Department of Orthopaedics, Andhra Medical College, Visakhapatnam. RESULTS The functional results were graded based on Flynn et al grading (Table -1). Results were graded with cosmetic and functional factors separately. CONCLUSION Closed reduction with percutaneous fixation gave good to excellent result in majority of cases. Open reduction and fixation should be reserved for cases which do not get reduced by closed reduction with two or more attempts, open fractures and fractures with vascular injury.

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