الفهرس | Only 14 pages are availabe for public view |
Abstract Supracondylar fracture is a very common elbow injury and represents approximately 16.6% of all childhood fractures. Accounting for 75% of all paediatric elbow injuries. The peak age range in which most supracondylar fractures occur is 5 to 6 years. Supracondylar fractures generally occur as a result of a fall onto the outstretched hand with the elbow in full extension.Extension-type injuries occur in 95% of cases and associated neurovascular injuries are reported in between 5% and 30%. Supracondylar fracture is commonly classified according to Gartland. This system was modified by Wilkins to allow for rotational deformity: type I (undisplaced), typeIIA (angulated, posterior cortex intact, no rotation), typeIIB (angulated, posterior cortex intact, rotational deformity), and type III (displaced with no cortical contact). An elbow fracture should be suspected in a child with elbow pain or a child who fails to use the upper extremity after a fall.Symptoms include pain and refusal to move the elbow Radiographic evaluation, generally including anteroposterior (AP) and lateral views of the entire upper extremity. Types I and IIA are mainly treated in an above-elbow posterior slab while in Type IIB and type III the preferred method is closed reduction and percutaneous pinning. Open reduction is indicated for irreducible fractures, vascular compromise and open injuries. Aim of the work This comparative study aims at reviewing and comparing the published studies that discuss the lateral and crossed techniques of wires fixation that are used in the treatment of supracondylar fractures of the humerus in children . We collected the published studies that discuss these two methods and we will compare them as regard: Feasibility of the technique Postoperative stability. Postoperative neurovascular injury. Range of motion. Pin tract infection. The inclusion criteria: • Patients below 15 years. • Both sexes • Patients treated by closed reduction and K wiring of supracondylar fractures of the humerus under general anaesthesia . • Gartland type II or III supracondylar fractures. • Closed fracture. The exclusion criteria: • Open fractures. • Gartland type I • Fractures with compartmental syndrome. • Fractures with pre-operative neurovascular injury. • Age above 15 years Flynn’s criteria for grading involving the evaluation of carrying angle loss (cosmetic), flexion and extension loss |