Percutaneous pin fixation of Gartland Type III supraconylar fractures of the humerus in Lusaka

Abstract

This was a prospective study of 40 children with severely displaced (Gartland Type  III) supracondylar fractures of the humerus treated by lateral percutaneous pin fixation together with a 'figure of eight' plaster casting. Their mean age was 6.9 years, the mean follow up was 2 years/ Eighteen (45%) of the patients had  excellent results with less than 5 degree loss of range of motion and minimal loss of carrying angle; thirteen (32.5%) had good results out of which seven had less than 10 degree loss of carrying angle and six had less than 20 degree loss of motion. Six (15%) had fair results due to transient nerve lesions. one of the six had 30 degree  loss of motion. The remaining three (7.5%) had poor results due to varus deformity that neededcorrective surgery. One case of pin tract infection was recorded. The average hospital stay was 1.2 days. The study confirmed that percutaneous pin  fixation is an effective, minimally invasive and safe method of fixation of these difficult fractures in our environment where optimum conditions for conservative management or internal fmation are not available. For conservative management there is poor radiographic and clinical follow up, while for internal fixation, there is a slightly higher infection rate and lack of facilities in our theatres. In spite of a slightly increased morbidity we recommend percutaneous fmation with figure of eight casting in all patients with severely displaced (Gartland III) fractures of the  umerus including compound ones as a compromise between conservative and open surgical treatment.

Key words: Percutaneous, pin fixation, Gartland type III, supracondylar, fractures,
and humerus.