Osteosynthesis with Kirschner wires in treatment of unstable supracondylar fractures of the humerus in children

Introduction Elbow fractures account for 7-9% of all fractures in childhood, while the supracondylar type is the most common (up to 70%). 84% of all supracondylar elbow fractures occur under the age of 10 years (most often between the age of 5 and 8). The aim of this study was to present the technique and results of treatment of supracondylar fractures with grade III fragment dislocation in pediatric population. Treatment included orthopedic repositioning and percutaneous pin fixation. Material and methods Over the period 1991-2000, 255 patients were hospitalized due to supracondylar fracture of the humerus with grade III fragment dislocation at the Pediatric Surgery Clinic in Novi Sad. All patients were aged 3-15 years. Orthopedic repositioning and percutaneous pin fixation under X-ray control was performed in 243 patients (95.29%). Results This study included 167 (65.5%) patients with full documentation. Extensor type of fracture was verified in 151 patients (90.42%). Male patients predominated over female patients - 119:48. The average follow-up period was 4,5 months. On the basis of clinical examination, and after completed rehabilitation, satisfactory results were obtained in 158 patients (94.6%), while in 9 patients the final outcome was unsatisfactory. Discussion Literature analysis points to advantages of orthopedic repositioning and percutaneous pin fixation, with certain modifications in the treatment of supracondylar elbow fractures with grade III dislocation. Conclusions Obtained results of treatment, advantages of this procedure, and our experience, suggest that orthopedic repositioning and percutaneous pin fixation is a procedure of choice in treatment of supracondylar elbow fractures with third III dislocation in children. Suprakondilarni prelomi humerusa predstavljaju najcesce prelome u predelu zgloba lakta, a posle preloma distalnog okrajka radijusa i najcesce prelome u decjem uzrastu uopste. Terapijski postupci kod suprakondilarnih preloma sa dislokacijom ulomaka III stepena su razliciti. Cilj ovog rada je da prikaze tehniku i rezultate lecenja suprakondilarnih preloma humerusa sa dislokacijom ulomaka III stepena kod dece, primenom ortopedske repozicije i perkutane fiksacije ulomaka Kirsnerovim iglama. Na Klinici za decju hirurgiju u Novom Sadu, u periodu 1991-2000. godine hospitalizovano je 255 dece sa suprakondilarnim prelom humerusa sa potpunom dislokacijom ulomaka. Ortopedska repozicija i perkutana fiksacija ulomaka pomocu dve Kirsner