![]() Cross pinning for supracondylar humerus fractures in children carries risk of iatrogenic ulnar nerve injuries 2 years after the pinning, one of the 17 children with ulnar nerve injury had persistent motor weakness and a sensory deficit medial pin was associated w/ ulnar n injury in 4% patients in whom the pin was applied w/o hyperflexion of the elbowĪnd in 15% in whom the medial pin was applied w/ elbow hyperflexed ulnar nerve injury was not seen in the 125 patients in whom only lateral pins were used configuration of the pins did not affect the maintenance of reduction of either type-2 fractures or type-3 fractures consider placing a temporary 2nd pin thru the lateral condyle to achieve even more stability insert lateral pin first to obtain stability while reduction is evaluated (avoids need to repeatedly insert medial pins if reduction is ![]() pin should avoid the olecranon fossa and should come to rest along the far cortex generally, the pin is aimed 35 deg upward and 10 deg posterior wire is inserted thru the capitellum, and then the distal humeral physis because the center of the capitellum is in line w/ anterior aspect of humeral shaft, the pin must be directed slightly posteriorly insertion point is in the center of lateral condyle (capitellum) Safe Zone for Superolateral Entry Pin Into the Distal Humerus in Children: An MRI Analysis ![]() avoid directing pins too far anterior or posterior w/ children younger than 5-6 years, use 0.062 smooth K wire pins need to be smooth w/ trochar point w/ posterolateral displacement, place arm in maximum internal rotaiton on the flourscopy platform, and insert the lateral pin first w/ posteromedial displacement, place arm in maximum external rotation on flourscopy platform, and insert the medial pin first pins should cross proximal to the frx at an angle of about 30 deg to the humeral shaft consider applying sterile "coband" to keep elbow flexed, which then allows arm to be externally rotated to achieve a lateral in preparing for crossed pinning, keep elbow hyperflexed to maintain reduction 2 lateral pins may not permit full elbow extension, thus preventing full assessment of carrying angle medial and lateral pin insertion provides better stabilization either two lateral pins, or one lateral and one medial pin may be used and both should penetrate the cortex Conclusion: Close reduction and percutaneous fixation with K-wire in Gartland III fracture in children is safe and effective treatment method with minimal hospital stay and less complications.- has become standard technique for stabilizing types II & type III frx One patient ulnar nerve injury, after 3 months nerve explored that was contused, symptoms resolved afterwards. According to Flynn’s criteria cosmetic results were excellent in 54 (90%) and good in 6 (10%) patients and functional results were excellent in 54 (90%), good in 4(7%), fair in 2 (2%) and poor in 1(1%) patient. All patients are of extension type fracture. Right side was involved in 37(62%) and left side was involved in 23 (38%) patients. 42 (70%) boys and 18 (30%) girls with age ranging between 2 to 10 years. Results: All the 60 children with Gartland type III supracondylar humerus fracture included in this study. Clinical results were evaluated using the Flynn’s criteria. Material & methods: 60 children sustaining a Gartland type III supracondylar humerus fractures less than 1 week old that was treated by closed reduction and percutaneous pinning. Setting: Department of Orthopedics Civil Hospital Karachi. Objectives: The objective of this study is to assess the functional outcome of close reduction and percutaneous K- wire fixation in supracondylar humeral fracture (SCHF) Gartland type III fractures in children. Supracondylar Humerus fracture (SCHF), closed reduction and percutaneous pinning (CRPP), Open reduction internal fixation (ORIF) Abstract Jinnah Postgraduate Medical Center, Karachi.įatima Memorial College of Medicine and Dentistry, Lahore. Dow University of Health Sciences Civil Hospital Karachi. ![]()
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