Lateral versus crossed K wire fixation for displaced supracondylar fracture humerus in children: Our experience

Lateral entry and crossed Kirschner (K) wire fixation configuration for treating displaced suprcondylar humerus fracture in children has always been shrouded in controversy as to which is superior. As the closed K wire fixation is the standard of treatment for these fractures, we performed a prospective study comparing the two methods. A prospective study comparing any reduction loss between the two groups was undertaken. Major end points documented were loss of fracture reduction and ulnar nerve injury, in addition clinical alignment, Flynn grade, range of motion, function, and complications. The operative procedure was standardized. Sixty two patients were studied, 32 and 30 in cross K wire and lateral K wire entry group respectively. Two cases of iatrogenic ulnar nerve injury was documented in crossed K wire fixation group but it was insignificant (p value=0.336). No significant difference was observed in terms of change in Baumann or humerocapitellar angle, carrying angle, elbow range of movement. Both techniques are equally effective. Ulnar nerve injury can be minimized by taking certain precaution as in text.