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LATERAL THREE PIN FIXATION FOR SUPRACONDYLAR FRACTURES IN CHILDREN

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Author Details : Hayat Ahmad Khan, Mohammad Ashraf Khan, Mohammad Shahid Bhat, Naseemul Gani, Prof Munir Farooq

Volume : 1, Issue : 2, Year : 2015

Article Page : 103-106

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Abstract

Introduction: Paediatric Supracondylar fractures are the commonest elbow injuries encountered in the emergency departments. Most commonly they are the result of a fall on an outstretched hand that causes hyperextension of the elbow. The extension-type supracondylar humeral fractures account for 95% to 98% of all supracondylar fractures. Displaced fractures are treated with closed reduction and percutaneous pinning. However the method of pinning has been a matter of debate (lateral entry vs cross pinning). The issue with the lateral entry pinning like loss of reduction and ulnar nerve injury with the cross pinning method has always kept a doubt in the surgeons mind regarding the method of pinning. The present study was aimed to see functional results of using three lateral pins in type II and III supracondylar fractures and to look for any complications occurring thereafter.

Methods: Forty consecutive patients of type II and III SC fractures were taken up for the study. Three lateral pins were used for all fractures. Using the Flynn criteria, the results were graded as excellent, good, fair or poor by comparing the carrying angle and range of motion with the opposite side.

Results: Among the cohort of forty patients we had 25 males and 15 females. The mean age group was 6.5 + 3.2. Sixteen patients had type II fracture while as 24 had type III Gartlands fracture. The union occurred in all cases. At the final follow up, 87.5% patients showed excellent results 10% showed good and 2.5% fair results. There was no case of poor results. There were no iatrogenic nerve palsies, and no patient required additional surgery.

Conclusion: Lateral three pin fixation is a good method for displaced supracondylar fractures and has little or no chances for ulnar nerve injury. This method has an easy learning curve among orthopaedic residents. A randomised control trail comparing it with other methods involving a larger series is needed to look for the effectiveness of this technique.

Keywords: Supracondylar fractures, Lateral three pin fixation, Iatrogenic nerve injury.

How to cite : Khan H A, Khan M A, Bhat M S, Gani N, Farooq P M, LATERAL THREE PIN FIXATION FOR SUPRACONDYLAR FRACTURES IN CHILDREN. Indian J Orthop Surg 2015;1(2):103-106

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