[Closed reduction and percutaneous pinning for acute type III extension- Supracondylar fracture of distal humerus in children.].
OBJECTIVE
Closed reduction of acute type III (according to Gartland) supracondylar extension fractures of the distal humerus and unicondylar pin fixation.


METHODS
Type III and unstable type II supracondylar fractures.


METHODS
Swelling of the elbow. Compartment syndrome.


METHODS
Radiographs of both elbows in the anterior-posterior and lateral projections.


METHODS
Supine with arm on arm board. General anaesthesia.


METHODS
Closed reduction through manipulation under fluoroscopic control. Fixation with 2 Kirschner wires introduced percutaneously through the lateral condyle. Long arm cast for 4 to 5 weeks.


METHODS
Radiographs on the first postoperative day, 1 week later and at time of cast and pin removal 4 to 5 weeks postoperatively. At that time active mobilisation of the elbow is started. Follow-up for 1 to 2 years is recommended.


METHODS
Damage of ossific nucleus of physis. Damage to neurovascular structures. Wire migration. Pin tract infection.


RESULTS
Out of 82 children (mean age 6.5 years) 73 had a follow-up of more than 6 months. 80.8% had good or excellent results. 15.1% had a decrease of the carrying angle of more than 10 degrees (4.1% more than 20 degrees ). There were 2 pin tract infections and 1 iatrogenic transient ulnar palsy.
Cheng
J C
JC
Pediatric Orthopaedic Service Department of Orthopaedics & Traumatology The Chinese University of Hong-Kong, Prince of Wales Hospital, Shatin, N. T., Hong-Kong.
Lam
T P
TP
Shen
W Y
WY