Outcome analysis of lateral pinning for Gartland Ⅲ supracondylar fractures in children

ZHU Danjiang; WANG Qiang; SUN Baosheng; SONG Baojian; FENG Wei; LIU Dingwu

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Medical Journal of the Chinese People Armed Police Forces ›› 2020, Vol. 31 ›› Issue (9) : 740-744.

Outcome analysis of lateral pinning for Gartland Ⅲ supracondylar fractures in children

ZHU Danjiang, WANG Qiang, SUN Baosheng, SONG Baojian, FENG Wei, LIU Dingwu

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Abstract

Objective To evaluate the efficacy of lateral divergent or parallel pin fixation using smooth K-wires for the operative management of Gartland type Ⅲ supracondylar humerus fractures in children. Methods A retrospective analysis of 138 cases of Gartland type Ⅲ supracondylar humeral fractures treated in Beijing Children’s Hospital between February 2017 to February 2019 was conducted. According to fixation methods, the patients were divided into the lateral divergent pin fixation group and the lateral parallel pin fixation group. The clinical features of the two groups and Flynn scores at the last follow-up were compared and analyzed statistically. Results A total of 134 patients were followed up for 6-24 months (mean 16 months). There was no significant difference in clinical characteristics between the two groups. Postoperative evaluation was conducted by Flynn standards. By Flynn’s function standard, the excellent and good rate of parallel group was 93.7%, compared to 90.3% in the divergent group, with no statistically significant difference. By Flynn’s aesthetic standards, the excellent and good rate of the parallel group was 92.1%, and that of the divergent group was 90.1%, so there was no significant difference between the two groups. There were no complications, such as fracture redisplacement, latrogenic nerve injury or cubitus varus. Conclusions Our series demonstrates that both lateral divergent and parallel pin fixations are effective and safe approaches to Gartland type Ⅲ supracondylar humerus fractures in children.

Key words

lateral parallel K-wires / lateral divergent K-wires / supracondylar humerus fracture

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ZHU Danjiang, WANG Qiang, SUN Baosheng, SONG Baojian, FENG Wei, LIU Dingwu. Outcome analysis of lateral pinning for Gartland Ⅲ supracondylar fractures in children[J]. Medical Journal of the Chinese People Armed Police Forces. 2020, 31(9): 740-744

References

[1] Khoshbin A, Leroux T, Wasserstein D, et al. The epidemiology of paediatric supracondylar fracture fixation: a population-based study [J].Injury,2014, 45(4):701-708.
[2] Barr L V. Paediatric supracondylar humeral fractures: epidemiology, mechanisms and incidence during school holidays[J].J Child Orthop,2014,8(2):167-170.
[3] Gartland J J. Management of supracondylar fractures of the humerus in children [J]. Surg Gynecol Obstet, 1959,109:145-154.
[4] Flynn J C, Matthews J G, Benoit R L. Blind pinning of displaced supracondylar fractures of the humerus in children. Sixteen years’experience with long term follow-up[J]. J Bone J Surg Am,1974, 56: 263-272.
[5] Gadgil A, Hayhurst C, Maffulli N. Elevated, straight-arm traction for supracondylar fractures of the humerus in children [J].J Bone Joint Surg Br, 2005, 87(1): 82-87.
[6] Oztürkmen Y, Karamehmetoglu M, Azboy I. Closed reduction and percutaneous lateral pin fixation in the treatment of displaced supracondylar fractures of the humerus in children [J]. Acta Orthop Traumatol Turc, 2005, 39: 396-403.
[7] Foead A, Penafort R, Saw A, et al. Comparison of two methods of percutaneous pin fixation in displaced supracondylar fractures of the humerus in children[J]. J Orthop Surg (Hong Kong), 2004, 12(1): 76-82.
[8] Lee S S, Mahar A T, Miesen D, et al. Displaced pediatric supracondylar humerus fractures: biomeehanieal analysis of percutaneous pinning techniques[J]. J Pediatr Orthop, 2002, 22(4): 440-443.
[9] Omid R, Choi P D, Skaggs D L. Supraeondylar humeral fractures in children [J]. J Bone Joint Surg Am, 2008, 90(5):1121-1132.
[10] Silva M, Knutsen A R, Kalma J J, et al. Biomechanical testing of pin configurations in supracondylar humeral fractures: the effect of medial column comminution[J]. J Orthop Trauma, 2013, 27(5): 275-280.
[11] Larson L, Firoozbakhsh K, Passarelli R, et al.Biomechanical analysis of pinning techniques for pediatric supracondylar humerus fractures[J]. J Pediatr Orthop, 2006, 26(5): 573-578.
[12] Hamdi A, Poitras P, Louati H, et al. Biomechanical analysis of lateral pin placements for pediatric supracondylar humerus fractures[J]. J Pediatr Orthop, 2010,30(2):135-139.
[13] Gottschalk H P, Sagoo D, Glaseret D, et al. Biomechanical analysis of pin placement for pediatric supracondylar humerus fractures:does starting point, pin size, and number matter? [J]. J Pediatr Orthop, 2012, 32(5):445-451.
[14] Lee Y H, Lee S K, Kim B S, et al. Three lateral divergent or parallel pin fixations for the treatment of displaced supracondylar humerus fractures in children [J]. J Pediatr Orthop, 2008, 28:417-422.
[15] Skaggs D L, Cluck M W, Mostofi A, et al. Lateral-entry pin fixation in the management of supracondylar fractures in children [J]. J Bone Joint Surg Am, 2004, 86-A: 702-7.
[16] Babal J C, Mehlman C T, Klein G. Nerve injuries associated with pediatric supracondytar humeral fractures:a meta-analysis [J]. J Pediatr Orthop, 2010,30(3): 253-263.
[17] Slobogean B L, Jackman H, Tennant S, et al. Iatrogenic ulnar nerve injury after the surgical treatment of displaced supracondylar fractures of the humerus: number needed to harm, a systematic review[J]. J Pediatr Orthop, 2010, 30(5): 430-436.
[18] Bauer C A, Lee B M, Bae D S, et al. A systematic review of medial and lateral entry pinning versus lateral entry pinning for supracondylar fractures of the humerus [J]. J Pediatr Orthop, 2007, 27(2): 181-186.
[19] Green D W, Widmann R F, Frank J S, et al. Low incidence of ulnar nerve injury with crossed pin placement for pediatric supracondylar humerus fractures using a mini-open technique [J]. J Orthop Trauma, 2005,19(3): 158-63.
[20] Sapkota K, Shrestha B. Study of supracondylar fracture of distal humerus in children and its management with lateral k- wire fixation [J]. Nepal J Med Sci, 2014, 3: 38-43.
[21] Guy S P, Ponnuru R R, Gella S, et al. Lateral entry fixation using three divergent pins for displaced paediatric supracondylar humeral fractures [J]. ISRN Orthop, 2011, 2011: 137372.
[22] Lee S, Park M S, Chung C Y, et al. Consensus and different perspectives on treatment of supracondylar fractures of the humerus in children [J]. Clin Orthop Surg, 2012, 4(1): 91-97.