Closed reduction With percutaneous pinning versus Open reduction and internal fixation in the treatment of extension supracondylar humeral fractures

Abstract

Background: - much attention has been paid to the problem of malreduction of supracondylar fractures of the humerus in children .in past, cubitus varus or cubitus valgus frequently thought to occur because of growth arrest of the distal humeral physis rather than because of malreduction of the fracture.Patient and methods: -We managed 72 patients with Gartlands type three supracondylar humeral fractures. fractures during the period between November 2006 and December 2008(with two years follow up)at al Sader and al Manathera hospitals .There were 36 cases treated by closed reduction with Percutaneous pinning method and 36 cases treated by open reduction and internal fixation method in five to twelve years old children.The results:-The results were assessed by using the modified scoring system of Flynn et al ,Regarding closed reduction and Percutaneous pinning method, the outcome was excellent in17( 47%), good in 12(33%), and fair in 6(17%)case, and poor in1(3%) but with the open reduction and internal fixation method the outcome was excellent in10(28%), good in10( 28%), fair in 11(30.5%) and poor in 5( 13.5%).Conclusions:-We concluded that the closed reduction and Percutaneous pinning method is superior to open reduction and internal fixation method in that it shortens the average time for healing and it offers a good functional factors with minimum risk of infection. The aim of the study The aim of this study is to determine whether closed reduction and Percutaneous pinning method results in a better outcomes at tow years follow up after the injury compared with those after open reduction and internal fixation. In the treatment of Gartlands type three posterior supracondylar humeral fractures in children.