Percutaneous pinning versus open reduction k wire fixation in Gartland type iii supracondylar fracture of humerus in children

Abstract

Background: In children, Supracondylar humeral fractures are regarded to be the second most common fracture. Supracondylar fractures can occasionally be one of the most difficult fractures to treat. Various treatment methods are available for this fracture, depending on its kind and associated conditions.

Objective: The aim of this study was to investigate the efficacy of open reduction K wire fixation and percutaneous pinning for children with Gartland type iii supracondylar humerus fractures.

Material and method: The current prospective study was conducted at the department of the Orthopedic Surgery Unit 2, of the Bolan Medical Complex Hospital, Quetta from January 1, 2022 to 31, December, 2023 after taking permission from the ethical board of the institute. A total of 88 children of both gender and different age groups (2 to 13 years old) were enrolled. The participants of the study were classified in to two groups. 44 underwent percutaneous pinning using an image intensifier and 44 had open reduction.  At 2, 4, 8, and 12 weeks, both groups were evaluated clinically for function improvement and radiographically for fracture union. The efficacy of both techniques was evaluated using the Flynn grading system. Data was analyzed using SPSS version 23. The two methods' results were compared using the Chi-square test. P ˂ 0.05 was regarded significant.

Results: A total of 88 individuals with Gartland type iii humerus fractures were included in this study, 44 in each group. Out of which 22(22.7%) were females and 68 (77.27%) were males. 34(77.2%) of the children in the percutaneous pinning group had excellent functional results, 8(18.1%) had good functional outcomes, and 2(4.5%) had fair functional outcomes. 28 (63.3%) of the children in the open reduction group had outstanding functional results, 11 (25%) had good  out comes  3 (6.8%) had fair  and 2 (4.5%) had poor outcomes (p > 0.05). Hospital stay, surgical complications, intentional effects, and mean time for radiological union did not differ between the groups (p>0.05).

Conclusion: This study concluded that treating children with Gartland type iii supracondylar fractures of the humerus, percutaneous pinning is a safer and more effective technique than open reduction with K wire fixation