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Clinical and radiographic outcomes after paediatric supracondylar humeral fractures treated with combined intramedullary and lateral wire fixation: our experience in fifty-one cases

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Abstract

Purpose

Displaced supracondylar humerus fractures in children are known for their high rate of complications and require urgent surgical treatment. Basically, there are two methods of fracture fixation: the lateral pin technique and the crossed pin technique. However, the best technique remains debated. The aim of this study was to evaluate the clinical and radiographic outcomes of our method of fixation using combined intramedullary and lateral wires for treatment of displaced supracondylar humeral fractures in paediatric patients.

Method

Fifty-one paediatric patients were treated for displaced supracondylar humeral fractures. The method of fracture fixation used consists of two Kirschner wires inserted one intramedullary and the other laterally. Clinical and radiographic outcomes were assessed at last follow-up.

Results

According to Gartland’s classification, 17 fractures (33%) were type 2 and 34 (67%) were type 3. The mean follow-up period was 7.8 months. Functional outcome according to Flynn’s criteria was satisfactory in all cases with 92% graded as excellent or good. Cosmetic outcome according to Flynn’s criteria was satisfactory in all cases. Radiologically, at last follow-up, the mean Baumann angle was 69° (63–82°) and the mean lateral capitellohumeral angle was 41° (32–50°).

Conclusion

Patients managed with combined intramedullary and lateral wires experience satisfactory results. Moreover, this technique, without risk for the ulnar nerve, can be interesting in the treatment of infrafossal fractures and fractures with anterior displacement.

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Availability of data and materials

The datasets used and analysed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Authors and Affiliations

  1. Orthopaedics Department, Ibn El Jazzar Hospital, Université de Sousse Faculté de Médecine de Sousse, Sousse, Tunisia

    Aymen Ben Fredj, Hedi Rbai, Farouk Chatbouri, Marouene Berriri & Anouar Boughattas

  2. Radiology Department, Ibn El Jazzar Hospital, Université de Sousse Faculté de Médecine de Sousse, Sousse, Tunisia

    Abderrahmen Daadoucha

Authors
  1. Aymen Ben Fredj
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  2. Hedi Rbai
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  3. Farouk Chatbouri
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Contributions

Aymen Ben Fredj: contributed to the clinical data collection and prepared the manuscript.

Hedi Rbai: contributed to supervision and validation.

Farouk Chatbouri: contributed to writing and editing of the manuscript.

Marouene Berriri: contributed to the conceptualization of the manuscript.

Abderrahmen Daadoucha: contributed to the design of study and performed the final revision of the manuscript.

Anouar Boughattas: contributed to data collection and analysis.

Corresponding author

Correspondence to Aymen Ben Fredj.

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Ethical approval

We recruited participants in orthopaedic outpatients, and gathered the information necessary for the study. Written consent was obtained from all parents before the examination of all children.

Consent to participate

All parents of children included in this study gave their written informed consent to participate.

Consent for publication

The authors affirm that parents of children included in this study gave their written informed consent for the data to be published.

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The authors declare no competing interests.

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Fredj, A.B., Rbai, H., Chatbouri, F. et al. Clinical and radiographic outcomes after paediatric supracondylar humeral fractures treated with combined intramedullary and lateral wire fixation: our experience in fifty-one cases. International Orthopaedics (SICOT) 47, 2901–2906 (2023). https://doi.org/10.1007/s00264-023-05765-2

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  • DOI: https://doi.org/10.1007/s00264-023-05765-2

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