A comparative study of two percutaneous pinning techniques (Cross K wire vs Lateral K wire) for Gartland type III pediatric supracondylar fracture of the humerus

Author(s): Dr. Sandip Patil, Dr. Nishant Gaonkar, Dr. Prashant Pandey, Dr Kumar Shubham, Dr. Rutvik Shah, Dr. Amit Garud and Dr. Anshul Pancholiya

Abstract: Background: Supracondylar fractures of humerus are one of the most common fractures in paediatric age group. Closed reduction and percutaneous K-wire fixation is one of the most commonly used treatment modality in Gartland type 3 fractures. A prospective randomized controlled study was undertaken to compare whether parallel k wires are better in terms of the stability, functional outcome and iatrogenic ulnar nerve as compared to cross k wire (medial and lateral). Material and methods: This is a prospective comparative randomized controlled trial. A total of 30 patients of displaced supracondylar fracture aged between 5-13 years, without any compound injury or comminution were enrolled for the study and randomly divided into two groups, each of 15 patients. One group was assigned treatment of crossed pinning and other group with lateral pinning respectively and outcome was evaluated on basis of pain, motion, stability and function according to Mayo’s elbow score and follow-up was maintained for a period of 45 days and statistical significance was calculated. Results: After assessment of 15 patients in each group we found out that mean mayo score was 98 in cross pinning group and 96.83 in lateral pinning group. This difference is statistically not significant. Conclusion: In our study we conclude that, lateral pinning is an equally good treatment choice in these fractures and especially for grossly swollen elbows. Also, risk of ulnar nerve injury during placement of medial pin is eliminated in lateral parallel k wires. Both the methods offer consistently satisfactory functional and cosmetic results.

DOI: https://doi.org/10.22271/ortho.2017.v3.i4j.91