Closed Reduction and Percutaneous Pinning for Supracondylar Fractures of Humerus in Vietnamese Children

Open Access Maced J Med Sci. 2019 Oct 15;7(24):4194-4198. doi: 10.3889/oamjms.2019.355. eCollection 2019 Dec 30.

Abstract

Background: Pediatric supracondylar humerus fracture (SHF) is a complicated injury which can result in severe sequela. Nowadays, closed reduction and percutaneous pinning (CRPP) is the most popular treatment.

Aim: This study had two aims (1) checking the result of treating pediatric SHF patients without neurovascular injury by CRPP under image intensifier, and (2) analysing neurovascular complications of CRPP in treating these patients.

Methods: We conducted a research on 42 patients from February 2018 to March 2019. The age of patients ranged from 3 to 11 years old, with a mean of 5. There was a male predominance with a male / female ratio of 3/1. The average duration of the procedure was 46 minutes, and there was no failed case.

Results: Result evaluation based on Flynn criteria (1974): 85.74 % excellent, 9.5% good, 2.38% fair, and 2.38% poor. There was 1 patient how got ulnar nerve injury complication after medial-lateral crossed pinning, making up 2.38% of all cases. This case was a late admission - 3 days after being injured - and the elbow was badly swollen, so locating the medial condyle for pin placement was very problematic, this the ulnar nerve could be damaged during K-wire pinning. The K-wires are removed after 4 weeks.

Conclusion: CRPP under image intensifier in treating pediatric supracondylar humerus fracture is an effective treatment and with good treatment result.

Keywords: CRPP; Flynn ‘s criteria; Garland classification; Supracondylar of the humerus fracture.