Crossed Wires versus Two Lateral Wires in Management of Supracondylar Fracture of the Humerus in Children in the Hands of Junior Trainees.
- Citation:
- Abdelkarim, M., A. Hosny, N. M. N. Abdelatif, M. M. Hegazy, W. R. Awadallah, S. A. Khaled, M. A. A. Azab, W. Elnahal, and H. Mohammady, "Crossed Wires versus Two Lateral Wires in Management of Supracondylar Fracture of the Humerus in Children in the Hands of Junior Trainees.", Journal of orthopaedic trauma, 2015 Oct 6.
Abstract:
OBJECTIVES: The objective was to evaluate and compare the outcome of the crossed and the lateral pin configurations in the management of supracondylar (SC) humeral fractures in children in the hands of junior trainees.
DESIGN: Prospective Randomized Controlled Trial.
SETTING: Level I Trauma Center.
PATIENTS: 60 children with Supracondylar humeral fractures. The mean age was 5.1 (1.5 - 9) years. The minimum follow up period was 6 months, with no patients lost to follow up.
INTERVENTION: 30 patients were managed by crossed and 30 by the lateral method. All surgeries were done by junior trainees in their first three years of training.
MAIN OUTCOME MEASUREMENTS: Postoperative stability, ulnar nerve injury, range of motions and pin tract infection.
RESULTS: The crossed configuration was stable in all the patients while the lateral method was less stable in 20% of the cases as the distal fragment rotated in five patients and posteriorly displaced in one patient. The difference was statistically significant with a p value of 0.031. Ulnar nerve neurapraxia occurred in one patient from the lateral group and it recovered in the 4th month while no ulnar nerve injury occurred in the crossed configuration group. Two patients in the lateral group lost approximately 10 of elbow flexion.
CONCLUSIONS: This prospective randomized controlled trial showed that the crossed pin configuration method provided more stability than the lateral pin configuration especially in the hands of junior trainees in their first three years of training and the difference was statistically significant.
LEVEL OF EVIDENCE: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.