Comparative Study of Cross and Lateral Fixations on Supracondylar Humerus Fracture among Children
Abstract
Background: Management of Gartland type III supracondylar humerus fractures is conducted by open and closed repositioning. An adequate reposition and a stable and accurate fixation are desperately needed to prevent fixation failure, deformity, and complication. The study aims to compare the clinical and radiological results between crossed and lateral fixation techniques.
Subjects and Method: The study was a retrospective study toward Gartland type III SCHF children in Dr. Soetomo Hospital, Surabaya, Indonesia from 2013–2016. The dependent variable is Supracondylar humerus fracture. Independent variables were the type of fixation option, clinical functional test, degrees of satisfactory, and radiology evaluation. The radiology parameter used was Skaggs criteria. An observation was conducted for the occurrence of complications in the form of infection and peripheral nerve injury. All data were analyzed using Kolmogorov Smirnov and Fischer exact test.
Results: The study discovered 28 patients consisted of 20 males and 8 females with an age range from 3 – 13 years old with an average age in crossed fixation group was 7.6 years and in lateral fixation was 4.7 years. The injury sides were 46.4% right elbow and 53.5 % left elbow. Among the crossed fixation group, there were 54.5 % left elbow and 45.5 % right elbow. Among lateral fixation group, there were 50% left side and 50% right side. There was no significant difference in clinical functions, radiology as well as complication in the form of infection and peripheral nerves injury.
Conclusion: There is no difference of functional clinical, radiology result as well as post-surgery complication in the form of infection and peripheral nerves injury between crossed fixation technique and lateral fixation technique.
Correspondence: Komang Agung Irianto. Department of Orthopedics and Traumatology, Faculty of Medicine, Universitas Airlangga/ Dr. Soetomo Hospital, Surabaya. Email: komang168@yahoo.com. Mobile: +62811336080.
Indonesian Journal of Medicine (2020), 05(01): 31-37
https://doi.org/10.26911/theijmed.2020.05.01.05
References
Balakumar B, Madhuri V (2012). A retrospective analysis of loss of reduction in operated supracondylar humerus fractures. Indian J Orthop. 46: 6907.
Davis RT, Gorczyca JT, Pugh K (2000). Supracondylar humerus fractures in children. Comparison of operative treatment methods. Clin Orthop Relat Res: 376: 49-55.
Gartland JJ (1959). Management of supracondylar fractures of the humerus in children. Surg Gynecol Obstet: 145–154.
Gordon JE, Patton CM, Luhmann SJ, Bassett GS, Schoenecker PL (2001). Fracture stability after pinning of displaced supracondylar distal humerus fractures in children. J Pediatr Orthop, 21(3): 313–318
Kalenderer O, Reisoglu A, Surer L, Agus H (2008). How should one treat iatrogenic ulnar injury after closed reduction and percutaneous pinning of pediatric supracondylar humeral fractures? Injury, 39(4): 463–466. https://doi.org.10.1016/j.injury.2007.07.016
Kasser JR (1992). Percutaneous pinning of supracondylar fractures of the humerus. Instr course lect: 41: 385-390.
Kocher MS, Kasser JR, Waters PM, Bae D, Snyder BD, Hresko MT (2007). Lateral entry compared with medial and lateral entry pin fixation for completely displaced supracondylar humeral fractures in children: A randomized clinical trial. J Bone Jt Surg Am, 89(4): 706–712. https://doi.org.10.2106/JBJS.F.00379
Lee EH (2000). Supracondylar Fractures of the humerus in Children Back to basics. Singapore Med J; 9: 423-424.
Lins RE, Simovitch RW, Waters PM (1999). Pediatric elbow trauma. Orthop Clin North Am, 30: 119. https://doi.org.10.1016/s0030-5898(05)70066-3
Otsuka NY, Kasser JR (1997). Supracondylar fractures of the humerus in children. J Am Acad Orthop Surg, 5: 19–26. https://doi.org.10.5435/00124635-199-701000-00003
Rasool MN (1998). Ulnar nerve injury after K-wire fixation of supracondylar humerus fractures in children. J Pediatr Orthop, 18: 686–690.
Skaggs DL, Cluck MW, Mostofi A (2004). Lateral entry pin fixation in the management of supracondylar fractures in children. J Bone Joint Surg Am, 86(4): 702-707. https:// doi.org. 10.2106/00004623-200404000-00006
Wang X, Feng C, Wan S, Bian Z, Zhang J, Song M, Shao J, Yang X (2012). Biomechanical analysis of pinning configurations for a supracondylar humerus fracture with coronal medial obliquity. J Pediatr Orthop B, 21: 495–498. https://doi.org.10.1097/BPB.0b01-3e328355d01f
