Treatment of Pediatric Supracondylar Fractures - A Comparison of Conventional Cross K-Wiring Versus Dorgan’s Technique

Cross K-Wiring vs Dorgan’s Technique in Pediatric Supracondylar Fractures

Abstract

Background: Pediatric supracondylar fractures are commonly managed with closed reduction and internal fixation (CRIF) with Kirchner's wires (K-wires), in different configurations, while the main objective remains stable fixation. Objective: This study aimed to compare functional and radiological outcomes, rate of iatrogenic ulnar nerve injury, operative time, and radiation exposure between conventional cross K wiring and Dorgan’s Technique. Study Design: Prospective study. Settings: Department of orthopedic surgery, Mayo hospital (King Edward Medical University), Lahore, Pakistan. Duration: From April 2024 to December 2024. Methods: Patients were divided into the standard group (group S) and Dorgan's technique group (group D), each with 36 patients. Results were compared, and statistical tests were applied with significance at p < 0.05. Results: Of 72 children, 48 were boys and 24 were girls. The mean age was around 7 years in both groups. Differences in mean surgical duration and radiation exposure were not significant between the two techniques.  (p = 0.359 and 0.897, respectively). Post-operative iatrogenic ulnar nerve injury occurred in 3 cases (8.5%) in group S and none in group D. The Difference in Flynn's criteria results for both groups was not significant. (p = 0.190). The difference in post-operative radiological outcome was also statistically not significant between the two groups. (p=0.309 for Bowman's angle and p = 0.55 for Anterior humeral line). Conclusion: Dorgan’s technique has comparable results to standard cross-K wiring and is better regarding the safety of the ulnar nerve in the surgical management of supracondylar fractures.