Aravindan Kalamegam1, Saravana Kumar Kadirvelu2, Bharath Narayanasamy3, Vignesh Ramaiyah Vaithilingam4
Supracondylar fracture in children when it is displaced, it is very difficult to reduce the fracture. That too after reduction, maintaining the reduction is very difficult. While reducing the fracture in closed reduction with lateral pinning first the result is not predictably good. Cross pinning will be giving mechanically stable fixation than lateral pinning alone. Lateral pinning alone imparts less rotational stability of fracture.
Our aim of study is to prevent rotational instability by putting medial pinning first by avoiding the ulnar nerve injury using radiological assistance followed by lateral pinning.
MATERIALS AND METHODS
One hundred and six cases of displaced supracondylar fracture were included in study. The mean age of the patient was 7 yrs. (3-12 yrs.), the male and female patient ratio was 72:34 and left side was involved in 63 patients whereas right side in 43 patients. The most common mode of trauma was fall from height on outstretched hand with elbow in extension. All the 106 patients were consecutively admitted. Patient had extension type of injury with 63 patients had Gartland type III fracture and 43 had Gartland type II fracture. Posteromedial displacement was noted in 63 patients whereas posterolateral displacement noted in 43 patients. In all cases, medial K wire was first inserted after closed reduction, then after stabilising the fractured rotation using image guidance. Lateral K-wire was removed on 3 weeks (21 days) and follow up was done at 6 weeks and 12 weeks when they were evaluated according to Flynn’s criteria.
Results were graded according to Flynn’s criteria.
Medial K wire technique provides stable fixation and rotational stability has been correlated according to this technique.