Efficacy of minimally invasive small-incision-assisted reduction with percutaneous Kirschner wire fixation in pediatric supracondylar humerus fractures

Abstract

Objectives: To retrospectively evaluate whether minimally invasive small-incision-assisted reduction with percutaneous Kirschner wire fixation (MIAR-PKWF) provides superior clinical outcomes compared to conventional closed reduction with Kirschner wire fixation (CR-KWF) in pediatric supracondylar humerus fractures (SCHFs), focusing on surgical outcomes, postoperative recovery, and elbow joint function.

Methods: A total of 100 pediatric SCHF cases were included and divided into either an observation group (MIAR-PKWF, n=55) or a control group (standard CR-KWF, n=45) based on their treatment approach. Outcome measures included operative time, recovery indicators, radiographic and serological parameters, elbow joint function, elbow range of motion, complications, and post-reduction swelling.

Results: In comparison with the control group, the observation group exhibited significantly improved surgical outcomes, accelerated rehabilitation, and better elbow joint function and mobility, radiographic indices, and serological markers. Additionally, the observation group experienced fewer complications and milder post-reduction swelling.

Conclusion: MIAR-PKWF is more effective in optimizing surgical outcomes, expediting postoperative rehabilitation, and improving elbow function in pediatric SCHF patients.

Keywords: Supracondylar humerus fractures in children; elbow joint functionality; minimally invasive small incision-assisted reduction; percutaneous Kirschner wire fixation; surgical outcomes.

Figure 1

Comparison of surgical outcomes between the two groups. A. Comparison of operation time between the observation (n=55) and control (n=45) groups. B. Comparison of hospitalization time between the observation (n=55) and control (n=45) groups. C. Comparison of the first-attempt reduction success rate between the observation (n=55) and control (n=45) groups. Note: **P<0.01 versus control group.

Figure 2

Comparison of postoperative recovery parameters between the two groups. A. Comparison of clinical healing time between the observation (n=55) and control (n=45) groups. B. Comparison of fracture healing time between the observation (n=55) and control (n=45) groups. Note: *P<0.05, **P<0.01 versus control group.

Figure 3

Comparison of elbow joint mobility between the two groups. A. Comparison of extension degree between the observation (n=55) and control (n=45) groups. B. Comparison of flexion degree between the observation (n=55) and control (n=45) groups. Note: *P<0.05 versus control group.

Figure 4

Comparison of radiographic parameters between the two groups. A. BA measurements in two groups. B. CA measurements in two groups. C. TA measurements in two groups. Note: BA, Baumann’s angle; CA, carrying angle; TA, tilt angle. *P<0.05, **P<0.01, versus control group.

Figure 5

Comparison of serum biomarkers between the two groups before and after treatment. A. BGP. B. BALP. C. IGF-1. D. NPY. Note: BGP, osteocalcin; BALP, bone-specific alkaline phosphatase; IGF-1, insulin-like growth factor-1; NPY, neuropeptide Y. *P<0.05, **P<0.01, versus baseline levels within group; #P<0.05, versus control group.