OUTCOMES OF CLOSED REDUCTION AND PERCUTANEOUS KIRSCHNER-WIRE PINNING UNDER FLUOROSCOPY FOR SUPRACONDYLAR HUMERAL FRACTURES IN CHILDREN
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Abstract
Objectives: To describe the clinical characteristics and radiographic features, and to evaluate the treatment outcomes of supracondylar humerus fractures in children treated by closed reduction and percutaneous Kirschner wire fixation under fluoroscopic guidance at the National Children’s Hospital.
Subjects and methods: A descriptive case-series study with longitudinal follow-up of 58 patients diagnosed with Gartland type II and III supracondylar humerus fractures (modified by Wilkins), treated by closed reduction and percutaneous Kirschner wire fixation under fluoroscopic guidance at the National Children’s Hospital from January 2025 to December 2025.
Results: The study included 58 patients. The mean age was 5.74 ± 2.24 (2 – 9) years, with a male-to-female ratio of 1.4:1. The left arm was fractured in 69.0% of cases. The leading cause was domestic accidents (89.7%). All patients underwent surgery within one week of injury. Clinically, 100% of patients presented with pain, swelling, and limited elbow flexion–extension; preoperative nerve injury was present in 3.4%, and there were no vascular injuries requiring intervention. Type II fractures accounted for 79.3% and type III for 20.7%. The two-cross-wire configuration was the most frequently used (75.9%). The mean operative time was 39.55 ± 16.66 minutes. Good and fair reduction results were achieved in 94.8% by the shaft–metaphyseal angle and 91.4% by the Baumann angle. The pin-tract infection rate was 0%, with no secondary displacement; one case (1.7%) of iatrogenic ulnar nerve injury occurred due to technique, which underwent neurolysis surgery and recovered well. At 6 months, evaluation by Flynn’s criteria showed good and fair overall results in 93.1%, with no poor outcomes.
Conclusion: Closed reduction and percutaneous Kirschner wire fixation under fluoroscopic guidance is a safe and effective method with a small incision, few complications, and a short hospital stay, and is suitable for the treatment of type II and III supracondylar humerus fractures in children.
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Keywords
Pediatric supracondylar humerus fracture, closed reduction, percutaneous Kirschner wire fixation, fluoroscopy
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