COMPARISON OF THE TWO METHODS OF PERCUTANEOUS K – WIRE FIXATION IN DISPLACED SUPRACONDYLAR FRACTURE OF HUMERUS IN CHILDREN

Abstract

Objectives: To compare the effectiveness and safety of fractures treated by percutaneous medial–lateral

cross K-wire fixation and 2–lateral K-wire fixation.

Methodology: Randomized controlled trial was conducted from January 2008 to July 2009 in Orthopedics

unit of Hayatabad Medical Complex Peshawar. A total of 50 patients of displaced supracondylar fracture

of humerus presenting between age 1-12 years were randomly allocated in two groups of 25 patients in

each group and were subjected to medial lateral cross K wire fixation and 2 lateral K wire fixation.

Results: Mean age of patients was 7.02 ± 2.25 years.72% of patients with carrying-angle loss was

excellent results and 28% good results. The mean loss of elbow flexion and loss of elbow extension were

8.38o ± 3.10 and 7.26o ± 3.22 respectively. In Patients with med-lat cross K-wire fixation group 72 % were

excellent results and 28% good results, while similar results were found in 2-lateral K- wire fixation group.

The 4% iatrogenic ulnar nerve injuries occurred with the med-lat cross K-wire fixation group, while no

neurological injury occurred with 2 lateral K wire fixation with p value of 0.312. Hence, there was no

significant difference in the incidence of ulnar nerve injury between the two groups of patients.

Conclusion: Both techniques appear to be effective, 2 lateral K-wire fixation is as effective in term of

stability as medial-lateral cross K- wire fixation but with less chance of iatrogenic ulnar nerve injury.