Percutaneous Pinning for Pediatric Supracondylar Humeral Fractures: A Multicenter Evaluation
DOI:
https://doi.org/10.36283/ziun-pjmd14-2/020Abstract
Background: Pediatric supracondylar humeral fractures constitute a significant proportion of childhood injuries involving the elbow region, representing the predominant fracture pattern in this anatomical area. These injuries typically result from falls onto outstretched hands with the elbow in extension. This investigation aimed to assess the efficacy of percutaneous pinning techniques in the management of supracondylar humeral fractures among pediatric patients.
Methods: This investigation employed a cross-sectional design across multiple clinical centers, including the Orthopedic Department at Peoples University of Medical, Health Sciences for Women, and Civil Hospital Nawabshah, and in collaboration with the Foundation of Medical and Research Laboratories from December 2023 to January 2025. The study has been approved A total of 110 patients were recruited via convenience sampling technique. Comprehensive clinical evaluations were performed for each participant, with systematic documentation of findings in standardized assessment forms. Each participant undertook a comprehensive diagnostic evaluation, including essential baseline assessments and radiographic examination. Data analysis was performed utilizing SPSS version 21 software. For categorical variables including participant gender, fracture classification according to Gartland criteria (types II and III), carrying angle deviation, and Continuous variables, particularly participant age, were analyzed using mean and standard deviations.
Results: The demographic distribution among the 110 participants revealed 71 male patients (64.54%) and 39 female patients (35.45%). Outcome assessment utilizing Flynn criteria demonstrated carrying angle loss in 14 participants (12.72%), motion restriction in 7 participants (6.36%), and successful fracture healing in 89 participants (80.90%).
Conclusions: Percutaneous pinning represents an accessible, straightforward, effective, and economical intervention for pediatric supracondylar humeral fractures, yielding favorable functional and cosmetic outcomes at the elbow joint.
References
Pavone V, Vescio A, Accadbled F, Andreacchio A, Wirth T, Testa G, Canavese F. Current trends in the treatment of supracondylar fractures of the humerus in children: Results of a survey of the members of European Paediatric Orthopaedic Society. Journal of Children's Orthopaedics. 2022 Jun;16(3):208-19. https://doi.org/10.1177/18632521221106379
Ducic S, Stojanovic B, Lazovic M, Bukva B, Radlovic V, Bumbasirevic V, Djordjevic ML. T-condylar humerus fracture in children: treatment options and outcomes. International Orthopaedics. 2021 Apr;45:1065-70. https://doi.org/10.1007/s00264-020-04827-z
Santos IA, Cruz MA, Souza RC, da Fonseca Barreto LV, Monteiro AF, Rezende LG. Epidemiology of supracondylar fractures of the humerus in children. Archives of health investigation. 2024 Jan 31;13(1):18-23. https://doi.org/10.21270/archi.v13i1.6324
Vaidya SV. Supracondylar Humerus Fractures in Children: Epidemiology and Changing Trends of Presentation. Int J Paediatric Orthopaed 2015;1(1):3-5.
Bahaeddini MR, Senemari MH, Beromi MS, Aminian A, Tabrizian P, Mohammadyahya E, Tayyebi H. Epidemiological Characteristics of Pediatric Supracondylar of Humerus Fractures in a Tertiary Hospital in Iran. Archives of Bone and Joint Surgery. 2024;12(5):333. doi: 10.22038/ABJS.2024.73619.3409
Tangadulrat P, Adulkasem N, Suganjanasate K, Wongcharoenwatana J, Ariyawatkul T, Kaewpornsawan K, Chotigavanichaya C, Eamsobhana P. Is subclassification of Gartland extension-type pediatric supracondylar fracture into types IIA and IIB necessary for treatment decision? A result of pediatric orthopedist’s survey and review of literature. Journal of Pediatric Orthopaedics B. 2023 Jul 1;32(4):378-86. DOI: 10.1097/BPB.0000000000001035
Shah M, Agashe MV. Supracondylar humerus fractures: classification based treatment algorithms. Indian Journal of Orthopaedics. 2021 Feb;55(1):68-80. https://doi.org/10.1007/s43465-020-00285-2
Liu Y, Shi W, Zhao H, Li Y, Li J, Xun F, Canavese F, Xu H. Closed reduction and percutaneous pinning versus open reduction and internal fixation for Jakob type 3 lateral condyle fractures in children. International Orthopaedics. 2022 Oct;46(10):2291-7. https://doi.org/10.1007/s00264-022-05476-0
Zhu S, Zheng Y, Jiang Y, Yin H, Zhu D. Open versus closed reduction internal fixation for lateral condyle humeral fractures in children: a systematic review and meta-analysis. Journal of Orthopaedic Surgery and Research. 2023 Apr 26;18(1):322. https://doi.org/10.1186/s13018-023-03808-3
Shah M, Agashe MV. Supracondylar humerus fractures: classification based treatment algorithms. Indian Journal of Orthopaedics. 2021 Feb;55(1):68-80. https://doi.org/10.1007/s43465-020-00285-2
Pretell Mazzini J, Rodriguez Martin J, Andres Esteban EM. Surgical approaches for open reduction and pinning in severely displaced supracondylar humerus fractures in children: a systematic review. Journal of children's orthopaedics. 2010 Apr;4(2):143-52. doi:10.1007/s11832-010-0242-1
Kow RY, Low CL, Awang MS. Supracondylar Humerus Fractures in Infants and Toddlers: An Unexplored Area. Journal of InvestIgatIve surgery. 2023 Jan 1;36(1):1-2. https://doi.org/10.1080/08941939.2022.2136803
Barber-Vidal I, Miranda I, Miranda FJ. Orthopedic or surgical treatment in gartland type ii supracondylar humerus fractures: A systematic review. Indian Journal of Orthopaedics. 2024 Aug 17:1-9. doi.org/10.1007/s43465-024-01227-y
Astawa P, Maharjana MA, Adisthanaya S, Putra MW, Putra AS, Savio SD. Close reduction percutaneous pinning (CRPP) versus open reduction internal fixation (ORIF) for pediatric supracondylar humerus fractures gartland type II and III: a systematic review and meta-analysis. Journal Of The Indonesian Medical Association. 2021 Sep 21;71(4):187-93. https://doi.org/10.47830/jinma-vol.71.4-2021-389
Smith J, Chhina H, Sidhu P, Brussoni M, Pike I, Cooper A. Paediatric elbow fractures and public play spaces: adherence to standards for children’s playground equipment and surfacing. BMJ paediatrics open. 2021 Nov 11;5(1):e001125. doi: 10.1136/bmjpo-2021-001125
Micheloni GM, Novi M, Leigheb M, Giorgini A, Porcellini G, Tarallo L. Supracondylar fractures in children: management and treatment. Acta Bio Medica: Atenei Parmensis. 2021 Jul 26;92(Suppl 3):e2021015. doi: 10.23750/abm.v92iS3.11725
Chong HH, Qureshi A. Pediatric distal humeral supracondylar fracture-achievement of optimal pinning configuration. Acta Orthop Belg. 2022 Jun 1;88(2):245-54. doi.org/ 10.52628/88.2.9691
Li Y, Feng Y, Chu X, Yuan Y, Yuan Y, Sun J. Minimally invasive techniques utilizing the “Joy Stick” method for managing irreducible flexion-type supracondylar fractures of the humerus in older children. Journal of Orthopaedic Surgery and Research. 2024 Jul 27;19(1):441. https://doi.org/10.1186/s13018-024-04922-6
Meng C, Meng Z, Huang X, Zhao F, Yang Q. A meta-analysis of closed reduction percutaneous pinning and open reduction with pin fixation of pediatric humeral lateral condylar fracture. Frontiers in Pediatrics. 2023 Jun 30;11:1205755. DOI 10.3389/fped.2023.1205755 DOI:
Younis A, Kaar K. Percutaneous Pinning for Proximal Humerus Fractures: Insights From a Five-Year Retrospective Study. Cureus. 2024 Dec 29;16(12). 10.7759/cureus.76600
Bhakta AK, Rahman MZ, Mobarok H, Kumar SA, Kabir MH, Sadi SM, Sahid SM, Mondol PK. Closed Reduction and Percutaneous Cross K-wire Fixation: Management of Displaced Supracondylar Fracture of the Humerus (Gartland Type-III) in Children. Saudi J Med Pharm Sci. 2024;10(7):447-54. DOI: 10.36348/sjmps.2024.v10i07.004
Zhu D, Wen Y, Wang Q, Son B, Feng W. Conservative versus surgical treatment of Gartland type II supracondylar humeral fractures in children. Journal of Pediatric Orthopaedics B. 2024 Nov 1;33(6):568-73. DOI: 10.1097/BPB.0000000000001170
Kaya Ö, Gencer B, Çulcu A, Doğan Ö. Extra lateral pin or less radiation? A comparison of two different pin configurations in the treatment of supracondylar humerus fracture. Children. 2023 Mar 14;10(3):550. https://doi.org/10.3390/children10030550
Patil P, Madhav VN, Alshadidi AA, Saini RS, Aldosari LI, Heboyan A, Mosaddad SA, Bin Hassan SA, Chaturvedi S. Comparative evaluation of open tray impression technique: investigating the precision of four splinting materials in multiple implants. BMC Oral Health. 2023 Nov 8;23(1):844. https://doi.org/10.1186/s12903-023-03583-x
Križanović V, Grgić K, Spišić J, Žagar D. An advanced energy-efficient environmental monitoring in precision agriculture using LoRa-based wireless sensor networks. Sensors. 2023 Jul 12;23(14):6332. https://doi.org/10.3390/s23146332

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