Afsar Khan, Muhammad Zahid Shah, Quratulain Shafique, Saad Dildar Khattak, Abdus Samad, Javid Ullah Khan, Khan Karim Afridi.
Outcome of Pediatric Supracondylar Humeral Fractures managed by Percutaneous Lateral K-wire fixation.
Pak J Surg Jan ;37(4):278-82.

Objective: To assess the outcome of pediatric supracondylar humeral fractures managed by percutaneous lateral k-wire fixation. Location and Period: Orthopedics and Trauma Unit, MTI Khyber Teaching Hospital, Peshawar, KPK, Pakistan from August 2017 to July 2019. Material and Methods: This prospective case series comprised of forty pediatric supracondylar humeral fractures managed by percutaneous lateral k-wires fixation. Outcome was analyzed as excellent, good, fair and poor according to Flynn`s criteria14 at final follow up (6 months). Results: Out of 40 children, 29 (72.5%) were boys and 11 (27.5%) were girls. Average age at the start of the study was 6.5+-1.72(2SD) years. In 31 (77.5%) patients, left elbow was involved while in 9 (22.5%) of patients, right elbow was involved. 13 (32.5%) patients had type II while 27 (67.5%) patients had type III supracondylar humeral fracture according to Gartland`s classification system. The average operating time in minutes was 46.38+-6.46 SD. All fractures united in 4-6 weeks time. 71.43% patients showed excellent outcome, 22.86% patients showed good outcome while 5.71% patients showed fair outcome. No case of poor outcome was seen. Apart from pin tract infection in 3 patients, no other post-operative complications were reported. Not a single patient required additional surgery. Conclusion: Percutaneous lateral k-wire fixation for managing pediatric displaced supracondylar humeral fractures had excellent outcome in most of our patients. We consider lateral pinning technique as a method of choice with the benefit of providing adequate mechanical stability and almost no chance of ulnar nerve injury. Further randomized controlled trials comparing lateral versus cross pinning techniques may be carried out to confirm our results.

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