Percutaneous K-wiring for Gartland type III supracondylar humerus fractures in children

OBJECTIVE: To assess the ability of closed reduction and percutaneous K-wire fixation, to obtain and maintain an adequate reduction, and thereby achieve satisfactory end results.

METHODS: A prospective study conducted on 60 children over 28 months at Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India, from March 2003 to June 2005, in which Gartland type-III supracondylar fracture humerus were treated by closed reduction and percutaneous pinning, either from lateral side only or from medial side also, under image intensifier control.

RESULTS: There was no problem in union. Patients were graded by Flynn's criteria with excellent results in 88.88%, good in 4.44%, and fair in 2.24%, and poor in 4.44% cases. Only one patient had developed cubitus varus deformity and one had Iatrogenic Ulnar nerve palsy from medial pin, which recovered subsequently. The Baumann's angle was well with in the normal range of 66-840.

CONCLUSION: Percutaneous K-wire fixation is a safe and effective method for the management of Gartland type-III supracondylar fractures with minimal hospital stay and without risking vascular compromise.