Transolecranon and lateral Kirschner wire fixation for displaced supracondylar humeral fracture in children

Abstract

Introduction
Percutaneous pinning of supracondylar humerus fracture(SCHF) in children is an effective way to maintain the anatomic reduction of a displaced. closed reduction and percutaneous pinning (CRPP) had been considered the standard treatment for displaced SCHF in children.


Patients and methods
A prospective case series, was conducted at the emergency department of Helwan university hospital from February 2020 to September 2021. It includes 40 patients with Gartland type III fracture who presented to the orthopaedic casualty and were included in the study. Four patients (10%) had the transolecranon wire was directed intramedullary, 11 patients (27%) had the wire directed posterolaterally, and 16 patients (40%) had the wire directed posteromedially and 9 patients (23%) had the wire directed posteriorly.


Results
The mean age was 5.57 years (range from 2–12 years). The mean Baumann angle in the patients was (70.89 ± 2.40). The mean follow-up duration was 3 months (range from 3–3.2 months). with mean carrying angle was about (9.37 ± 2.52) and no one of the patients had an excessive deformity of carrying angle that required correction. Regarding ROM loss, there were 25, but always poor. A few complications occurred including pin tract infection and broken transolecranon wire and all were tolerable with no effect on the outcome.


Conclusion
The Transolecranon and lateral Kirschner wires fixation is an effective option that provides good stability with the little number of trials in the management of supracondylar fracture of the humerus in children, and the risk of nerve injury or fishtail deformity was avoided especially in the hands of junior trainees in their first 3 years of training.