Percutaneous transolecranon pinning and lateral pinning Vs lateral pinning in displaced supracondylar fractures of humerus in children: an observative study

Authors

  • Ramesh Chand Jindal Department of Orthopaedics, MMIMSR, Mullana, Haryana, India
  • Manjeet Singh Department of Orthopaedics, MMIMSR, Mullana, Haryana, India
  • H. S. Sandhu Department of Orthopaedics, MMIMSR, Mullana, Haryana, India
  • Gurwinder Singh Bal Department of Orthopaedics, MMIMSR, Mullana, Haryana, India
  • Harish V. K. Ratna Department of Orthopaedics, MMIMSR, Mullana, Haryana, India
  • Jasneet S. Chawla Department of Orthopaedics, MMIMSR, Mullana, Haryana, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20190536

Keywords:

Lateral pinning, Supracondylar fracture, Transolecranon pinning

Abstract

Background: Supracondylar fracture (humerus) is type of extra-articular fracture occurring in the distal metaphyseal site of humerus. It is almost exclusively a fracture of the immature skeleton, seen in children and young teenagers. Fractures around the elbow are a great challenge to orthopaedic surgeons. Clinical diagnosis may be difficult due to noncooperative patient and massive swelling around the elbow. Displaced type of supracondylar fractures poses problem not only in reduction but also in maintenance of reduced fracture   and   rapid   inclusion   of nerves and vessels.

Methods: The present study was conducted on 30 cases of displaced supracondylar fracture humerus in children, aged 2-14 years, who were treated by CRPP with either lateral entry of k-wires or a lateral wire and a vertical wire through olecranon (transolecranon).

Results: Both the Groups achieved 90% satisfactory results, but 10% unsatisfactory results recorded in Group A only rather than in Group B.

Conclusions: Although the transolecranon wire has the disadvantage of limiting the flexion and extension of the elbow, this does not influence the final-outcome much as the elbow is fixed in a POP splint for minimum 3 weeks-in all patients in both groups.

References

Wilkins KE. The operative management of supracondylar fractures. Orthop Clin North Am. 1990;21:269.

Bachman D, Santora S. Orthopedic trauma. In: Textbook of Pediatric Emergency Medicine, Fleisher GR, Ludwig S, et al. (Eds), Lippincott Williams and Wilkins, Philadelphia; 2006:1538.

Lins RE, Simovitch RW, Waters PM. Pediatric elbow trauma. Orthop Clin North Am. 1999;30:119.

Cheng JC, Shen WY. Limb fracture pattern in different pediatric age groups: a study of 3350 children. J Orthop Trauma. 1993;7(1):15-22.

Lord B, Sarraf KM. Paediatric supracondylar fractures of the humerus: acute assessment and management. Bri J Hos Med. 2011;72(1):M8-M11.

Boyd and Altenberg, 1944. Boyd HB, Altenberg AR: Fractures about the elbow in children. Arch Surg. 1944;49:213.

Houshian S, Mehdi B, Larsen MS. The epidemiology of elbow fracture in children: analysis of 355 fractures, with special reference to supracondylar humerus fractures. J Orthop Sci. 2001;6:312-315.

Gillingham BL, Rang M. Advances in children's elbow fractures. J Pediatr Orthop. 1995;15(4):419-21.

Landin LA. Fracture patterns in children. Acta Orthop Scand. 1983;202:13.

Farnsworth CL, Silva PD, Mubarak SJ. Etiology of supracondylar humerus fractures. J Pediatr Orthop. 1998;18(1):38-42.

Ruparelia DS, Patel DS, Zalawadia DA, Shah DS, Patel DSV. Study of carrying angle and its correlation with various parameters. NJIRM. 2010;1(3):28-32.

Beals RK. The normal carrying angle of the elbow. A radiographic study of 422 patients. Clin Orthop Relat Res. 1976:194-6.

Zimmerman NB. Clinical application of advances in elbow and forearm anatomy and biomechanics. Hand Clin. 2002;18:1-19.

Keats TE, Teeslink R, Diamond AE, Williams JH. Normal axial relationships of the major joints. Radiology. 1966;87:904-7.

Wael A, Mohammed A, Boghdady GW, Ali AM. Results of treatment of displaced supracondylar humeral fractures in children by percutaneous lateral cross-wiring technique. Strategies Trauma Limb Reconstr. 2008;3(1):1-7.

Aronson DD, Prager BI. Supracondylar fractures of the humerus in children: A modified technique for closed pinning.Clin Orthop Relat Res. 1987;219:174-84.

Pirone AM, Graham HK, Krajbich JI. Management of displaced extension-type supracondylar fractures of the humerus in children. J Bone Joint Surg Am. 1988;70(5):641-50.

Devkota P, Khan JA, Acharya BM, Pradhan NM, Mainali LP, Singh M, et al. Outcome of supracondylar fractures of the humerus in children treated by closed reduction and percutaneous pinning. J Nepal Med Assoc. 2008;47(170):66-70.

Balakumar B, Madhuri V. A retrospective analysis of loss of reduction in operated supracondylar humerus fractures. Indian J Orthop. 2012;46(6):690-7.

Maity A, Saha D, Roy DS. A prospective randomised, controlled clinical trial comparing medial and lateral entry pinning with lateral entry pinning for percutaneous fixation of displaced extension type supracondylar fractures of the humerus in children. J Orthop Surg Res. 2012;7:6.

Foead A, Penafort R, Saw S, Sengupta S. Comparison of two methods of percutaneous pin fixation in displaced supracondylar fractures of the humerus in children. J Orthop Surg. 2004;12:76-82.

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Published

2019-02-27

How to Cite

Jindal, R. C., Singh, M., Sandhu, H. S., Bal, G. S., Ratna, H. V. K., & Chawla, J. S. (2019). Percutaneous transolecranon pinning and lateral pinning Vs lateral pinning in displaced supracondylar fractures of humerus in children: an observative study. International Journal of Research in Medical Sciences, 7(3), 717–721. https://doi.org/10.18203/2320-6012.ijrms20190536

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Original Research Articles