Parteti Ritesh, Uikey Kishor, Kothale Jayant, Azlam P Mohamed, Mishra Prashant
Deptartment of Orthopedics, Government Medical College, Seoni, Madhya Pradesh, India.
J Orthop Case Rep. 2025 Aug;15(8):324-331. doi: 10.13107/jocr.2025.v15.i08.5984.
Supracondylar humerus fractures comprise 17% of all pediatric fractures and are second in frequency to forearm fractures. According to an epidemiological study, the incidence of fracture supracondylar humerus is 308/100000/year in the general population. It is also the most common pediatric fracture around the elbow. Fracture involving lateral condyle shows swelling, tenderness, and crepitus over lateral condyle, whereas in supracondylar fracture, tenderness and swelling involve medial supracondylar ridge and the lateral supracondylar ridge.
(1) To assess mechanical stability and functional mobility in cross, lateral divergent, lateral parallel, and three-pin Kirschner wire fixation. (2) To assess radiological outcome in cross, lateral divergent, lateral parallel, and three-pin Kirschner wire fixation.
This cross-sectional study was conducted in the hospital attached to Government Bundelkhand Medical College, Sagar, Madhya Pradesh, from July 2021 to August 2022. During this period, 60 cases of displaced supracondylar fractures of the humerus in children were treated with cross pinning and lateral pinning with Kirschner wires according to odd and even randomization.
A total of 60 participants were selected with a mean age of 8.6 (±2.6) years, a minimum was 4 years, and maximum were 12 years. Thirty-nine was male and 21 was female. Out of 60 cases, 17 (28.3%) cases were operated by two cross K-wire, 18 (30%) were by two lateral k-wire divergent, 15 (25%) were by two lateral K-wire parallel, and 10 (16.7%) cases were operated by three-pin (2 lateral and 1 medial). The carrying angle of the normal elbow was 11.8 ± 1.9, 11.9 ± 2.4, 11.0 ± 1.6, 11.7 ± 1.8 among two cross K-wire and two lateral (divergent), two lateral (parallel), three-pin K-wire groups, respectively. The differences in the angle in these groups were not statistically significant.
In our study, two lateral divergent K-wire or two lateral parallel K-wire fixation method provided safe, better functional and radiological outcomes as well as equal mechanical stability as compared to two cross K-wire or three pinning in most of the patients.
肱骨髁上骨折占所有儿童骨折的17%，在骨折发生率上仅次于前臂骨折。根据一项流行病学研究，肱骨髁上骨折在普通人群中的发病率为每年308/100000。它也是肘部周围最常见的儿童骨折。累及外侧髁的骨折表现为外侧髁肿胀、压痛和骨擦感，而在髁上骨折中，压痛和肿胀累及内侧髁上嵴和外侧髁上嵴。
（1）评估交叉克氏针、外侧发散克氏针、外侧平行克氏针和三枚克氏针固定的力学稳定性和功能活动度。（2）评估交叉克氏针、外侧发散克氏针、外侧平行克氏针和三枚克氏针固定的放射学结果。
本横断面研究于2021年7月至2022年8月在中央邦萨加尔政府本德尔汗德医学院附属医院进行。在此期间，根据奇偶数随机分组，对60例儿童肱骨髁上移位骨折患者采用交叉克氏针和外侧克氏针固定治疗。
共选取60名参与者，平均年龄8.6（±2.6）岁，最小4岁，最大12岁。男性39名，女性21名。60例中，17例（28.3%）采用两根交叉克氏针手术，18例（30%）采用两根外侧发散克氏针手术，15例（25%）采用两根外侧平行克氏针手术，10例（16.7%）采用三枚克氏针（2枚外侧和1枚内侧）手术。两根交叉克氏针组、两根外侧（发散）克氏针组、两根外侧（平行）克氏针组和三枚克氏针组的正常肘部提携角分别为11.8±1.9、11.9±2.4、11.0±1.6、11.7±1.8。这些组间角度差异无统计学意义。
在我们的研究中，与两根交叉克氏针或三枚克氏针固定相比，两根外侧发散克氏针或两根外侧平行克氏针固定方法在大多数患者中提供了安全、更好的功能和放射学结果以及同等的力学稳定性。
