Comparison of Efficacy Between Open and Close Reduction in Supracondylar Fracture of Humerus in Children using Flynn’s Criteria

Abstract

Background: In children, of all the elbow fractures 85% these occur in the distal humerus, supracondylar fractures are 55 to 75%. Reducing the fracture using closed technique with per-cutaneous wiring and pins is proposed by many surgeons for third fracture type. One of the excellent methods for the treatment of these type of fractures involving humerus bone in pediatric population is through internal fixation using K wire. Objective: To compare the efficacy between open and close reduction in supracondylar fracture of humerus in children using Flynn’s criteria. Study Design: A Randomized controlled trial. Settings: Orthopedics ward, Faisalabad Medical University, Faisalabad. Duration: 6 Months from 28 March 2018, 27 September 2018. Methodology: After taking approval from institutional ethical committee, patients were enrolled and randomly allocated in two groups. Patients in group A underwent open reduction and patients in group B underwent close reduction. Fracture fragments were reduced under vision in open reduction and under image intensifier in closed reduction and fixed with Kirshner's wires in crossing pattern. Patients were followed for 16 weeks postoperatively to assess the efficacy by using Flynn’s criteria as per operational definition. Results: In our study, mean age was calculated as 7.28+1.74 in Open reduction group and 7.37+1.88 years in Closed reduction group, 80%(n=52) in Open reduction group and 75.38%(n=49) in Closed reduction group were male while 20%(n=13) in Open reduction group and 24.62%(n=16) in Closed reduction group were females, comparison of efficacy between open and close reduction in supracondylar fracture of humerus in children using Flynn’s criteria shows that 89.23%(n=58) in Open reduction group and 93.85% (n=61) in Closed reduction group were treated effectively, p value was 0.344 showing insignificant difference. Conclusion:  We concluded that the efficacy of open and close reduction in supracondylar fracture of humerus in children using Flynn’s criteria is not significantly different, however, the open reduction may be adopted where the image intensifier is not available.