OPEN REDUCTION AND INTERNAL FIXATION IN IRREDUCIBLE SUPRACONDYLAR FRACTURES OF ELBOW IN PEDIATRIC PATIENTS

ABSTRACT
Objective: To evaluate results of open reduction and internal fixation (ORIF) in pediatric patients with extension type
III supracondylar elbow fractures.
Materials and methods: Thirty eight patients with extension type III supracondylar fracture of the elbow were included
in the study. All patients were treated between March 2014 to may 2015 by open reduction and internal fixation (ORIF)
with two cross k wires.
Results: Thirty eight patients were included in the study. There were 26 boys (68%) and 12 girls (32%). Mean age of
the patients was 6.5 years (03years –10 years). The right side elbow was involved in 11 patients (31%) while left side
was involved in 27 patients (69%). All the fractures were internally fixed by two crossed K-wires after open reduction.
According to Flynn’s criteria, 25 patients (65%) had excellent results, 10 patients (26%) had good results, 02 patients
(06%) had fair results and 01 patient (03%) had poor results. Pin-tract or surgical site infections were seen in three patients
(7.8%). In two patients infection resolved after removal of pins and antibiotic course while in one patient infection
resolved with oral antibiotics. Two patients had cubitus varus deformity at the end of the treatment. Temporary ulnar
nerve deficit occurred in 03 (08%) patients who recovered completely in twelve weeks time. Mean range of motion
(ROM) of the elbow was 20 – 130 degrees after one and half month postoperatively. Elbow ROM was equal to that of
normal side (0 - 140 degrees) after twelve weeks of operation. At last follow-up carrying angle of affected elbow was in
range of 8-10 degrees except in two patients who had cubitus varus deformity of the elbow.
Conclusion: Open reduction and internal fixation with two crossed K-wires is an easy and effective operative treatment
in supracondylar extension type III fracture of the elbow in pediatric patients, with a low complication rate.
Key words: Open reduction, internal fixation, supracondylar fracture.