Amjad Tahir, Firasat Majid, Muhammad Nasir Ali, Muhammad Asif Qureshi.
Treatment of old supracondylar fractures of humerus in children.
J Surg Pak Jan ;17(4):135-8.

Objective: To study the outcome of open reduction and fixation with K wires of supracondylar fractures of humerus in children presenting between 2–14 days after injury. Study design: Case series. Place & Duration of study: Department of Orthopaedics, B.V.Hospital Bahawalpur, from April 2009 to March 2010. Methodology: This study included patients with displaced extension type supracondylar fracture of the humerus (Gartland type III) who presented between 2-14 days post injury. Open reduction and internal fixation(ORIF) with crossed K-wire was done. The results were assessed by the criteria described by Flynn et al and Mark et al. The average age of patients was 4.5 year. The average hospital stay was 2 days (range 1–3 day). The average duration of follow-up was 15 months (range: 12-24 months). Results: Forty patients were managed during the study period. Eighteen (45%) 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 patients had 30 degree loss of motion. The remaining three (7.5%) had poor results due to varus deformity that needed corrective surgery. Conclusions: Delayed presentation of displaced supracondylar humerus fractures in children did not increase complication rates or unsatisfactory results following an open reduction and internal fixation with K wires. It is a safe and effective method of treatment even with delayed presentation of supracondylar fractures of humerus in children.

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