[Comparison of two approaches for the treatment of supracondylar fractures in children by K-wires]

Abstract

Objective: To explore the clinical effect between two approaches for the treatment of supracondylar fractures of humerus by K-wires in children.

Methods: From Jan. 2004 to Dec. 2006,117 children with supracondylar fractures of humerus were divided into two groups according to different methods of the K-wires fixation involving two K-wires group and three K-wires group. In two K-wires groups,there were 45 children including 31 boys and 14 girls with an average age of 5.6 years ranging from 1 to 11 years; according to Garland classification, 19 cases were type II, 26 cases were type III. In three K-wires groups, there were 72 children including 47 boys and 25 girls with an average age of 6.8 years ranging from 2 to 12 years; according to Garland classification, 22 cases were type II, 50 cases were type II. The movement and carrying angle of elbow joint were measured for all these patients. According to Flynn criteria for supracondylar fracture the results of two approaches with K-wires were compared.

Results: All patients were followed-up from 2 to 24 months (means 15.4 months). In two K-wires group, the results of Flynn were excellent in 27 cases, good in 12 cases, fair in 4 cases and poor in 2 cases, 41 cases gained bony healing, however, fail of fixation arosed in 4 cases and cubitus varus arosed in 2 cases. In three K-wires group, the results of Flynn were excellent in 60 cases, good in 11 cases and poor in 1 case, all cases of three K-wires group achieved bony healing after 6 weeks of operation, the function of joints recovered through exercise and cubitus varus arosed in one case after operation.

Conclusion: The technique of fixation with K-wires is a stable and reliable methods for unstable supracondylar fracture but medial-lateral three-pin fixation is better than one with two pins.