Screw fixation for supracondylar humerus fractures in children: a report of seventeen cases.

ABSTRACT

PURPOSE: Supracondylar fractures in the pediatric population are common. For years, K-wires have been the preferred method of surgical fixation. However, fixation with K-wires alone may lead to multiple complications. This study reports the results of surgical care of supracondylar humerus fractures using screw fixation with K-wires or screw fixation alone. METHODS: This study retrospectively reviewed all patients with supracondylar humerus fractures treated with screw fixation between 2007 and 2013. Patients treated only with smooth wires, or having a displaced medial epicondyle, or presenting with lateral condyle fractures were excluded from the study. Flynn's criteria were used to determine the outcome. RESULTS: Seventeen patients who met inclusion criteria formed the study group. All patients were followed until union, resolution of complications, and return to preinjury activity level. Satisfactory outcome was reported in 70.6% of patients with less than 15° loss of either flexion or extension. Mean time to union was 6.5 weeks (range 3.3-12.1 weeks). Screw fixation alone had a shorter mean time to union (5.5 weeks) than compared screw fixation with K-wires group (6.9 weeks). Full range of motion following surgical invention was associated with Flynn's criteria (p value = 0.044). CONCLUSION: Screw fixation for pediatric supracondylar fractures is a viable option to achieve healing and early motion in highly unstable fractures as well as fractures which require (1) increased stability, (2) maintenance of stability during wound checks in the immediate postoperative period and after discontinuation of the cast, or (3) if further exploration like associated vascular injury is warranted.