MANAGEMENT OF LATE PRESENTING DISPLACED SUPRACONDYLAR ELBOW FRACTURES - A NOVEL TECHNIQUE

Abstract

Delayed presentation of displaced supracondylar elbow fractures in children is a unique problem, but not uncommon in our hospital settings. The purpose of this study was to evaluate the results of our novel technique of closed manipulation and percutaneous pinning of these late presenting fractures.

We used this technique in fourteen children, with an average age of seven years five months, who presented after an average delay of sixteen days. Through a limited incision technique, manipulation was done using a long curved artery forceps (under image intensifier). Final realignment was obtained and cross k wire fixation done.

At follow-up (average twenty-two months) there were only four children who had cubitus varus greater than one hundred and needed corrective osteotomy. There were no neurovascular injuries. The other two patients with cubitus varus of sixty were satisfied with the appearance of their elbow. Final evaluation was done using Flynn criterion.

The procedure however is quite demanding and needs expertise in closed pinning techniques. Though this technique holds promise in managing the difficult “SUPRACONDYLAR DILEMA”, yet larger series and multicentric trials are needed to establish the efficacy.