title: [Percutaneous closed pin fixation of supracondylar fractures of the distal humerus in children].
abstract: OBJECTIVE
  Prevention of long-term angular and extension deformity of the elbow and restoration of full range of motion.
  
  
  METHODS
  Malalignment of > 20 degrees in the sagittal plane in children > 6 years. Rotatory displacement as well as displacement in the frontal plane.
  
  
  METHODS
  Severe cardiorespiratory diseases.
  
  
  METHODS
  In most cases, a closed reduction is possible. Fixation of the fracture with two percutaneous Kirschner wires from lateral and medial; the pins cross beyond the fracture line and penetrate the metaphyseal cortex.
  
  
  METHODS
  Elbow cast in 90 degrees flexion; the cast has to be split. Removal of cast and pins after 3-4 weeks. Occasionally physiotherapy required.
  
  
  RESULTS
  Between October 2005 and September 2006, 77 supracondylar fractures were treated. According to the classification of von Laer 31 were type I (no displacement), 14 type II, nine type III, and 23 type IV (wide displacement). 34 of them required operative treatment due to nine type III and 23 type IV displacements, as well as two cases with (unstable) type II. In all patients treated surgically, the elbow angle was successfully restored. At follow-up after 8-14 months, 32 had regained full range of motion. In two children, extension/flexion was 0-10-120 degrees and 0-10-140 degrees , respectively. Two deficits of the ulnar nerve due to the operation as well as one deficit of the median nerve and the radial nerve due to the initial trauma recovered completely. According to the Flynn Score 32 patients had an excellent outcome; one result was classified as good and one as satisfactory. On the Mayo Performance Score all patients reached 100 of 100 points.
authors.affiliation: Klinik für Kinderchirurgie, UK S-H Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany. kaiser@medinf.mu-luebeck.de
authors.forename: Martin M
authors.initials: MM
authors.lastname: Kaiser
authors.forename: Anna
authors.initials: A
authors.lastname: Kamphaus
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Massalme
authors.forename: Lucas M
authors.initials: LM
authors.lastname: Wessel
mesh_terms: D001858:Bone Nails; D002648:Child; D002675:Child, Preschool; D004551:Elbow Joint / Q000601:surgery*; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016896:Treatment Outcome; D000092464:Elbow Injuries