title: Transolecranon and lateral Kirschner wire fixation for displaced supracondylar humeral fracture in children.
abstract: OBJECTIVE
  To evaluate the outcome after closed reduction and pinning using a Kirschner wire inserted laterally and another inserted vertically through the olecranon for displaced supracondylar humeral fractures.
  
  
  METHODS
  39 boys and 11 girls aged 2 to 12 (mean, 7.27) years underwent closed reduction and pinning using a Kirschner wire inserted laterally and another inserted vertically through the olecranon for posteromedially (n=28), posterolaterally (n=7), or posteriorly (n=15) displaced extension-type supracondylar humeral fractures (Gartland types II and III).
  
  
  RESULTS
  Compared with the uninjured elbows, the injured elbows had a mean loss of flexion of 4.52º (p<0.001), a mean loss of extension of 1.7º (p=0.008), and mean change in carrying angle of 3.47º (p<0.001). According to the Flynn grading system, outcome was excellent in 35 patients, good in 9, fair in 2, and poor in 4. Outcome did not differ significantly between patients aged 2 to 4, 5 to 8, and 9 to 12 years or between those operated on within 24 hours of injury and those operated on 2 to 5 days after injury. One patient developed superficial pin tract infection, and 2 patients developed cubitus varus deformity. No patient sustained iatrogenic nerve injury.
  
  
  CONCLUSIONS
  Transolecranon vertical and lateral Kirschner wire fixation is a viable option for displaced supracondylar humeral fractures in children, especially when there is massive swelling.
authors.affiliation: Government Multi-Specialty Hospital, Chandigarh, India.
authors.forename: Anmol
authors.initials: A
authors.lastname: Sharma
authors.forename: Karamdeep
authors.initials: K
authors.lastname: Kahal
authors.forename: Shardaindu
authors.initials: S
authors.lastname: Sharma
mesh_terms: D000367:Age Factors; D001864:Bone Wires; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D056740:Olecranon Process / Q000601:surgery*; D011859:Radiography; D016059:Range of Motion, Articular; D061665:Time-to-Treatment; D016896:Treatment Outcome
keywords: bone wires; child; humeral fractures