Clinical and radiological results of pediatric supracondylar humerus fracture that operated closed reduction and percutaneus pinning

Aim: the aim of this study is to evaluate the radiological and clinical results of the patients diagnosed with extension-type supracondylar fracture treated using closed reduction and percutaneous pinning technique. Materials and Methods: The clinical and radiological results of the 88 patients who's admitted to the Tokat Gaziosmanpasa University Orthopedics and Traumatology Clinics between May 2016 and March 2019 operated for supracondylar humerus fracture were assessed in this study. Carrying angles measured by McRae method, range of motion, and cosmetic and functional scoring using these measurements which is defined by Flynn were performed. The measurements of Baumann angle, humerocapitellar angle, lateral humerocapitellar angle, residual sagittal deformity and rotational deformity were measured in the radiological assessment. Closed reduction and percutaneous fixation defined by Casiano were applied for surgical technique. Results: Thirty-two (36.4%) of the patients were female where 56 (63.6%) were male. Thirty-seven patients (42%) had right elbow fracture where 51 (58%) had left were detected. The follow-up period of the patients was between 1 and 14 years, which had a mean of 5.15±2.55. The mean age of the subjects was found as 6.02±2.8. The distribution of the patients according to Gartland classification is found as 23 (%26,1) of the patients Type IIa, 15 (%17) of the patients Type IIb, 39 (%44,3) of the patients Type III and 11 (%12,5) of the patients Type IV. All patients received osteosynthesis with cross-pin configuration. Osteosynthesis was performed by one lateral and one medial K wires in 48 (54.5%) of the patients, two lateral and 1 medial K wires in 33 (37.5%) of the patients, and 2 lateral and 2 medial K wires in seven (8%) of the patients. Elbow exercises were initiated at a mean of 4.1±0.8 weeks after operation. Kwires were removed at 6.17±1.26 weeks after control x-rays. Median nerve injury was developed in two patients in preopretive period where ulnar nerve injury was detected in one patient after operation. Spontaneous recovery was observed in these patients. All patients were evaluated according to the cosmetic and functional criteria defined by Flynn. Cosmetic results revealed 80 patients (90.9%) as perfect, five (5.7%) as good, three (3.4%) as fair. Functional findings showed 81 patients (92%) as perfect and seven (8%) as good. Conclusion: Closed reduction is an effective technique for the treatment of supracondylar humerus fractures.