Closed reduction and percutaneous pin fixation is considered
standard management for displaced supracondylar fractures of the
humerus in children. However, controversy exists regarding whether
to use pins from the lateral side or medial and latera
l side of the
elbow for fixation .
We performed this research to know the results of two ways of
treatment and to compare : 1- the risk of iatrogenic ulnar nerve
injury caused by pin fixation . 2- quality of fracture reduction in
terms of radiographic outcomes . 3- compare function of the elbow
and other surgical complications caused by pin fixation between two
ways.
The fixation of the humeral,s supracondylare fractures in children by percutaneous pinning is considered a new and good principle in without the disadvantages that appear by treating it by open reduction and internal fixation . A prespective and pers
pective study was done for 48 kids whose old was between 2 – 14 year, those kids were admitted and treated surgically by these two methods ( pinning and ORIF ) In AL-ASSAD hospital in LATTAKIA in TISHREEN-UNIVERSITY in 2014 The ages of patients were between 2 – 14 , female ratio was ( 62.5% ) and male ( 37.5% ) the common reasons for these fractures were sportive and home accidents and the dominant upper limb was left . Fractures were isolate in 90% of cases and we noted 4 cases with accompanied and nondisplaced fractures in forearm and wrist that were treated conservatively . Pins and cast were removed in the four weeks . The more common complications were the secondary displacement , movement limitation and cubitus varus. The percutaneous pinning stills an easy way in understanding and application and gives good results for long period functionally and cosmetically , and this way has no important complications which can be avoided .
The study included 40 cases of supracondylar humeral fracture in children whose
attended al-Assad University Hospital in Lattakia between 2013 and 2014. Patients' ages
ranged between 2 and 13 years , the ratio of males/female was 3,4/1. Greatest ra
nge of
injury in left arm 77,5% . Closed reduction and percutaneous pinning was used in 33
patients and open reduction with cross-wiring in 7 patients .Postoperative complications
occurred in seven(17,5%) patients. They consisted in iatrogenic nerve injuries in five
(12,5%) patients ,one case of infection around the pins ,and one case of nonunion, All
recovered without sequels.
Satisfactory outcomes were noted after 5 months of physical therapy in 32 (97%)
patients in
the percutaneous pinning group,and5 (71,4%) patients in the open reduction with
cross-wiring group .
