Alagesan Saravanan, Mohideen Sheik, Pradeep E, Kumar K V Arun, Ashwin V Y, Ajay B S Rithik
Department of Orthopaedics and Traumatology, Chettinad Hospital and Research Institute, Kelambakkam, Tamil Nadu, India.
Department of Orthopaedics and Traumatology, Aarupadai Veedu Medical College Hospital, Kirumampakkam, Puducherry, India.
J Orthop Case Rep. 2025 Jun;15(6):282-286. doi: 10.13107/jocr.2025.v15.i06.5738.
Supracondylar humerus fractures are the most common elbow injuries in children, accounting for approximately 60% of all pediatric elbow fractures, primarily occurring in the first decade of life. These fractures are often associated with complications such as compartment syndrome, neurovascular injury, Volkmann's ischemic contracture, and malunion. The most common complication is cubitus varus deformity. The preferred pinning techniques include either a crossed pin construct or two lateral pins. Among various treatment approaches, closed reduction with percutaneous K-wire fixation has been found to be the most effective, with minimal complications. This study aims to assess the functional and radiological outcomes of pediatric displaced supracondylar humerus fractures managed with closed reduction and percutaneous K-wire fixation.
35 consecutive patients meeting the study's inclusion and exclusion criteria were enrolled. Data are collected and analyzed using Microsoft Excel for statistical calculations.
In this study, 25 children (62%) sustained the fracture within the first decade of life. Males showed a higher incidence than females. The Mayo elbow scores recorded at 6 months was 96.01 ± 2.80. Pin tract infections were observed in 10 patients, while 3 cases presented with cubitus rectus. Clinical outcomes, evaluated using Flynn's criteria, showed fair outcome in 1 case, good outcomes in 3 cases, and excellent outcomes in 31 cases.
Percutaneous pinning after closed reduction, whether using a crossed configuration or lateral pinning remains the preferred treatment for supracondylar fracture of the humerus in pediatric patients. When performed with the proper technique, both configurations yield successful outcomes. This approach is a safe, economical, and least invasive option with low morbidity.
肱骨髁上骨折是儿童最常见的肘部损伤,约占所有小儿肘部骨折的60%,主要发生在生命的第一个十年。这些骨折常伴有诸如骨筋膜室综合征、神经血管损伤、Volkmann缺血性挛缩和畸形愈合等并发症。最常见的并发症是肘内翻畸形。首选的穿针技术包括交叉穿针结构或两根外侧穿针。在各种治疗方法中,经皮克氏针内固定闭合复位被认为是最有效的,并发症最少。本研究旨在评估经闭合复位和经皮克氏针内固定治疗的小儿移位肱骨髁上骨折的功能和影像学结果。
连续纳入35例符合本研究纳入和排除标准的患者。使用Microsoft Excel收集和分析数据以进行统计计算。
在本研究中,25名儿童(62%)在生命的第一个十年内发生骨折。男性发病率高于女性。6个月时记录的梅奥肘关节评分是96.01±2.80。10例患者观察到针道感染,3例出现肘伸直。使用弗林标准评估的临床结果显示:1例为一般结果,3例为良好结果,31例为优秀结果。
闭合复位后经皮穿针,无论是采用交叉构型还是外侧穿针,仍然是小儿肱骨髁上骨折的首选治疗方法。当采用适当技术进行操作时,两种构型均能取得成功结果。这种方法是一种安全、经济且创伤最小、发病率低的选择。