Afzal Saeed Awan, Mohsin-ur Rashid, Muhammad Saeed.
Supracondylar humerus fractures - experience at a forward treatment centre in Kashmir.
Pak Armed Forces Med J Jan ;68(3):497-501.

Objective: To assess the results of open reduction and internal fixation with K-wires for displaced Supracondylar humerus fractures in children in an isolated forward treatment centre (FTC) in Neelum valley. Study Design:Cross-sectional descriptive series. Place and Duration of Study:This study was carried out at a FTC which is located in Tehsil Headquarters Hospital Kel valley from Dec 2013 to Feb 2015. Material and Methods: It was a cross sectional descriptive study. Data was collected form 24 patients who came to FTC Kel with displaced supracondylar fracture from Dec 2013 to Feb 2015. They were assessed for age, sex, etiology, time of surgery, pattern of fracture, hospital stay, infection and range of motion. Results:In our study majority of patients were found to be between 5-6 years of age (66%). The majority of the patients were males (83%). The commonest cause was fall from mountain tracks (62%). In our study we had twenty (83%) patients who had grade III displaced fracture. Ninety one percent underwent operation on the same day as the occurrence of injury (91%) patients were discharged on 3rd post op day. Twelve percent Patients had pin track infection and (4%) patients had iatrogenic nerve palsy which recovered spontaneously. Four percent patients developed superficial wound infection. There was loss of range of motion in six patients ranging from 0-5 degrees. Functional results based upon Flynn’s grading system showed that we had 75% satisfactory result. Conclusion:We concluded that open reduction and internal fixation with k-wires at a remote station without the facility of image intensifier was safe and effective provided that the surgeon is confident in this procedure.

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