A Prospective Study on Clinical and Functional Outcome of Surgical Management Of supracondylar Fracture of Humerus in Children with Cross K -Wire Fixation

Parveez Ahmed Syed; Karthik Sagar S; Mahadev Gowda Prakhyath; Likhith Kumar L

doi:10.37022/wjcmpr.v8i2.412

Authors

Syed Parveez Ahmed Fellow in Arthroplasty, Department of Orthopedics, Bangalore Medical College and Research Institute, Bengaluru
Karthik Sagar .S senior Resident, Department of Orthopedics, Bangalore Medical College and Research Institute, Bengaluru.
Prakhyath Mahadev Gowda Senior Resident, Department Of Orthopedics, Bangalore Medical College And Research Institute, Bengaluru.
Likhith Kumar L Fellow in Arthroplasty, Department Of Orthopedics, Bangalore Medical College and Research Institute, Bangalore

Abstract

Background: Displaced supracondylar humeral fractures are common paediatric elbow injuries and may cause malunion, neurovascular complications, stiffness, and functional impairment. This study evaluated the clinical, radiological, and functional outcomes and complications of crossed percutaneous K-wire fixation following closed reduction.

Methods: A prospective study was conducted in 50 children younger than 12 years with displaced supracondylar humeral fractures. Patients with open fractures, vascular injury, malunion, or age >12 years were excluded. Fractures were classified using the modified Gartland classification. Clinical and radiological outcomes were assessed using elbow range of motion, carrying angle, Baumann’s angle, fracture alignment, and complications. Functional outcomes were graded using Flynn’s criteria at 4, 12, and 24 weeks.

Results: The study included 39 males (78%) and 11 females (22%), with a mean age of 7.12 ± 2.30 years. The left elbow was involved in 66%, and extension-type fractures accounted for 96%. Posteromedial displacement was most common (48%). Two K-wires were used in 56% and three in 44%. At follow-up, 74% had ≤5° loss of elbow motion, with a mean loss of 3.62 ± 3.68°. Loss of carrying angle was ≤5° in 86%, with a mean loss of 3.04 ± 2.96°. Flynn grading showed excellent outcomes in 86%, good in 10%, fair in 2%, and poor in 2%, giving 96% satisfactory results. Superficial pin-tract infection and movement restriction occurred in 14% each, while iatrogenic ulnar nerve palsy occurred in 4% and K-wire migration in 2%.

Conclusion: Crossed percutaneous K-wire fixation following closed reduction provides stable fixation and favourable clinical, cosmetic, and functional outcomes in appropriately selected children, although careful medial pin placement is essential to minimize ulnar nerve injury.

Keywords:

Supracondylar fracture, humerus, children, paediatric orthopaedics, crossed K-wire fixation, percutaneous pinning, closed reduction, Flynn criteria, elbow, functional outcome

DOI

https://doi.org/10.37022/wjcmpr.v8i2.412

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