Closed reduction vs open reduction and pinning in displaced supracondylar fracture humerus in children.

Supracondylar fractures of humerus in children account for approximately 60 % of fractures in this area. The fracture line passes through the thinnest area, through the olecranon fossa posteriorly and coronoid and radial fossa anteriorly .The treatment varies according to the type of fracture. In Gartland type 1 and some selected type 2 fractures, non operative management is done with above elbow slab. In type 3 and some displaced type 2 fractures, reduction can?t be achieved without internal fixation with k wires. The aim of the present study was to analyze the results of fixation of supracondylar fractures by open vs. closed reduction followed by internal fixation with k wires and assessing the union radiologically, complications associated with the procedure and restoration of range of motion and function of the elbow and to evaluate the results clinically regarding pain, stiffness, range of motion. A total of 40 cases were admitted for fracture supracondylar type 3. Out of them open reduction was done in 20 and in other 20 closed reduction was done. All 40 were fixed by internal fixation with k wires. The age of the patients in this study ranged from 4 yrs to 11 yrs. Males formed 75 %of the patients. 97.5 % fractures were extension types and the rest were flexion types. Left side was involved commonly(60 %). Duration from injury to surgery was an average of 23 hours. Mean procedure duration for closed group was 20 minutes and in open group was 70 minutes. Hospital stay in pt.s treated by closed reduction was 24 hrs(1 day). In pt.s treated by open reduction mean hospital stay was 5 days. Overall excellent results were found in 60 % in closed group and 35% in open group.