European Journal of Molecular & Clinical Medicine

The aim of this studyto compare functional outcome of close and open cross pinning in treatment of Gartland  type 3 supracondylar humerus fracture in children. All patients operated with mediolateral cross pinning were included in this study. The age range was 3-12 years at the time of surgery. All patients were followed till the fracture united radiologically. The diagnosis was based on conventional X-ray imaging

The aim of this study is to study outcome in posteromedial and posterolateral displaced supracondylar fracture humerus post operatively. All procedures and protocols used in this study had been approved by the medical ethics committee of our institution. Children with fractures are usually first seen in the casualty unit. The orthopaedic doctor on call will examine the child, assess the vascular and neurological status, and review the radiographs of the elbow. Evaluation of the neurology and vascular status was repeated in the ward. After obtaining the informed consent for the study and surgery, the patients would be kept fasted for surgery.
Result: There were only 10 patients in whom the result was rated as fair: 08 had posteromedial displacement and 02 had posterolateral displacement. 02 patients rated as poor, had posteromedial displacement.
Conclusion: From this prospective study, we concluded that high rates of neurovascular complications in supracondylar humerus fracture in children demand High index of suspicion in this fracture especially in POSTEROMEDIALLY displaced fractures. Posteromedialy displaced supracondylar fracture humerus should be considered as a red flag sign for neurovascular complications. Also better functional outcome is associated with cross k-wire fixation in Posterolateral displaced fracture.

Traditional treatment with closed reduction and application of plaster slab or cast is
inappropriate in the case of displaced supracondylar fractures of humerus as this method may
potentially lead to malunion & subsequent elbow deformity, as it is difficult to obtain
satisfactory reduction and to maintain the reduction due to distraction forces acting at the
elbow. Our study involved 40 children who had sustained displaced supracondylar fractures
(Gartland-Type III) who were treated in the Department of Orthopaedic at a Tertiary care
trauma center, between November 2018 to May 2020. 55% of our cases were in the age group
5-10 years, 60% were male & 40% female.
80% (n=32) of the cases had history of fall on outstretched hand, followed by 3% with fall on
flexed hand which is in concordance with the most common mode of injury established by
many studies. 70% of the cases had fracture of left supracondylar humerus as compared to
30% on the right side. 30 out 40 cases had postero-medial displacement of distal fragment &
remaining 10 cases had postero-lateral displacement.