• Dr. Tapas Kumer Talukder
• Dr. Md. Nazibullah
• Dr. Md. Mostafizur Rahman
• Dr. Mahbub Hasan

Introduction: Displaced supracondylar fractures of the humerus in children are common pediatric injuries treated by orthopedic surgeons. They are notorious for difficulty and maintenance of reduction, frequent involvement of neurovascular structures and also have a high rate of complications like serious neurovascular injuries and residual deformity if not reduced and stabilized in optimal position. No general agreement on the treatment is evident with controversy prevailing regarding the ideal timing of surgery, method of maintenance of reduction and configuration of the pin fixation. Amongst the various methods used for treating these fractures, closed reduction and percutaneous pin fixation has shown improved results. The aim of this study was to assess the short term outcome of treatment of this fracture using closed reduction and percutaneous pin fixation having different pin configuration. Materials and Methods: 32 children (25 boys, 7girls), of displaced supracondylar humeral fractures (10-Gartland type II and 22- Gartland type III) with fracture age less then 10 days, were included in this study. Duration of the study was between January 2018 and April 2019 (16 months). Mean age at the time of operation was 5 years (range 3-13 years), They were treated with closed reduction and percutaneous pin fixation with Kirschner’s wires having different configurations (Crossed wires, two lateral parallel wires, two lateral divergent wires, two lateral and one medial wires, trans olecranon fossa wires having four cortex fixation) under anaesthesia (general anaesthesia in 25 and brachial plexus block in 7 relatively older cooperative children), assuming fracture anatomy and post reduction stability under C arm image intensifier control. The ulnar nerve function and vascular status were examined preoperatively, intraoperatively, following reversal from anesthesia, at the time of discharge, at the end of one week and at the time of pin removal (average at 35 days, range 30-42 days). Each patient was kept in hospital for only one day. The average duration of follow-up was 8 months (3-16 months). The range of motion of the elbow was assessed clinically with goniometer. The results were evaluated according to the criteria of Flynn et al. Results: Union was achieved in all the patients (100%). Transient ulnar nerve palsy occurred in two patients (6.25 %), which showed complete clinical improvement in three months. Superficial pin tract infections were seen in two patients (6.25 %) that resolved after one week antibiotic treatment), and cubitus varus of 8-17 degrees in nine patients (28.12%). Myositis ossificans, deep infection or compartment syndrome were not encountered. According to the criteria of Flynn et al., the results were excellent in 23 (71.88%), good in 5 (15.62%), fair in 2 (6.25%), and poor in 2 patients (6.25%). Conclusion: Closed reduction and percutaneous pin fixation having different configurations assuming fracture personality proved an efficient, reliable, and safe method in the treatment of displaced supracondylar fractures of the humerus in children irrespective of pin configuration.

Displaced supracondylar fractures, Closed reduction, Percutaneous pin fixation, transolecranon pinning, Four cortex fixation

"Displaced supracondylar fracture humerus in children- Short term outcome of close reduction and percutaneous pin fixation having different pin configurations", International Journal of Emerging Technologies and Innovative Research (www.jetir.org), ISSN:2349-5162, Vol.7, Issue 6, page no.1059-1063, June-2020, Available :http://www.jetir.org/papers/JETIR2006486.pdf

"Displaced supracondylar fracture humerus in children- Short term outcome of close reduction and percutaneous pin fixation having different pin configurations", International Journal of Emerging Technologies and Innovative Research (www.jetir.org | UGC and issn Approved), ISSN:2349-5162, Vol.7, Issue 6, page no. pp1059-1063, June-2020, Available at : http://www.jetir.org/papers/JETIR2006486.pdf