A Comparative Study to Determine the Outcome of Supracondylar Fracture of Humerus in Children Treated with Percutaneous Cross Pinning Versus Two Lateral Pinning
Syed Usman Shah, Naseer Ullah Khattak, Abdul Rasheed Napar, Muhammad Tariq Khan, Amina Gul Shehzar Khan, Sami Ullah
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ABSTRACT
Objective: Analysis and assessment of anatomical refurbishment with
the use of percutaneous cross
pinning versus two lateral pinning
and to determine the functional consequences of these procedures, to evaluate
the hurdles faced in these treatment methodologies, and the comparison between
the patient acceptances in both methods.
Methods: This research was a comparative cross-sectional analysis
which was conducted at Orthopedics department of Ayub Teaching Hospital Abbottabad for
duration of six months i.e from March 2021 to August 2021. The sample size for the research was 50 patients who were
admitted both at the (outpatient department) OPD and in the emergency ward. All
the patients were clinically examined carefully and thoroughly, and all of
their details were recorded. Base line investigations and X-rays were performed
of every patient.
Results: Percutaneous cross pinning or two lateral pinning methods
were used to treat 50 patients suffering from supra-condylar fracture of
humerus. Two groups were formed, each had 25 patients. Group A consisted of
patients were treated from PCP, while group B patients were treated from TLP.
Among the patients of Group, A, 20(80%) were male, 5(20%) were female, with a
female: male ratio of 1:5, while in group B patients, 22(88%) were male, 3(8%)
were female, with a female: male ratio of 1:8. The average age of both the
groups was 7.30+3.30 years. The most prominent reason of fracture in the
designed study was fall during playing (54%), 24% patients reported falling
from bicycle, while only 22% patients had fallen from trees, the height of
which was around 5-7 feet. Postero-medial displacement was observed in 66%
patients, while Postero-lateral displacement was observed in 34% patients.
Among the list of complications, in TLP, 8% patients suffered from superficial
pin tract infection, 12% patients suffered from non-union, and 4% patients had
K-wire migration and 4% had Cubitus varus. On the other hand, in PCP group
patients, one patient developed superficial pin tract infection, 8% patients
had nonunion, and 4% patients had K-wire migration. When the results were
analyzed using the Flynn criteria, they were excellent (48% group A patients
versus 36% patients of group B), 32% patients in group A had good results and
28% in group B, 20% patients of group B versus 12% patients of group A were
regarded as fair, and 8% patients of group A versus 16% patients of group B
were considered as poor. The patients who carried angle loss were 12% of group
A versus 24% of group B, and who complained about loss of motion were 15%
patients of group A versus 25% patients of group B were classified according to
Flynn criteria
Conclusion: Percutaneous cross pinning is concluded as the better, and
more predictable treatment method in terms of management, as compared to two
lateral pinning method to treat the Supra-condylar fractures.
Key Words: Percutaneous cross pinning, two lateral pinning,
supra-condylar fracture, humerus