A Comparative Study to Determine the Outcome of Supracondylar Fracture of Humerus in Children Treated with Percutaneous Cross Pinning Versus Two Lateral Pinning

Abstract

Objective: Analysis and assessment of anatomical refurbishment with the use of percutaneous cross pinning versus two lateral pinning and to determine the functional consequences of these procedures, to evaluate the hurdles faced in these treatment methodologies, and the comparison between the patient acceptances in both methods. Methods: This research was a comparative cross-sectional analysis which was conducted at Orthopedics department of Ayub Teaching Hospital Abbottabad for duration of six months i.e from March 2021 to August 2021. The sample size for the research was 50 patients who were admitted both at the (outpatient department) OPD and in the emergency ward. All the patients were clinically examined carefully and thoroughly, and all of their details were recorded. Base line investigations and X-rays were performed of every patient. Results: Percutaneous cross pinning or two lateral pinning methods were used to treat 50 patients suffering from supra-condylar fracture of humerus. Two groups were formed, each had 25 patients. Group A consisted of patients were treated from PCP, while group B patients were treated from TLP. Among the patients of Group, A, 20(80%) were male, 5(20%) were female, with a female: male ratio of 1:5, while in group B patients, 22(88%) were male, 3(8%) were female, with a female: male ratio of 1:8. The average age of both the groups was 7.30+3.30 years. The most prominent reason of fracture in the designed study was fall during playing (54%), 24% patients reported falling from bicycle, while only 22% patients had fallen from trees, the height of which was around 5-7 feet. Postero-medial displacement was observed in 66% patients, while Postero-lateral displacement was observed in 34% patients. Among the list of complications, in TLP, 8% patients suffered from superficial pin tract infection, 12% patients suffered from non-union, and 4% patients had K-wire migration and 4% had Cubitus varus. On the other hand, in PCP group patients, one patient developed superficial pin tract infection, 8% patients had nonunion, and 4% patients had K-wire migration. When the results were analyzed using the Flynn criteria, they were excellent (48% group A patients versus 36% patients of group B), 32% patients in group A had good results and 28% in group B, 20% patients of group B versus 12% patients of group A were regarded as fair, and 8% patients of group A versus 16% patients of group B were considered as poor. The patients who carried angle loss were 12% of group A versus 24% of group B, and who complained about loss of motion were 15% patients of group A versus 25% patients of group B were classified according to Flynn criteria Conclusion: Percutaneous cross pinning is concluded as the better, and more predictable treatment method in terms of management, as compared to two lateral pinning method to treat the Supra-condylar fractures. Key Words: Percutaneous cross pinning, two lateral pinning, supra-condylar fracture, humerus