Trans-olecranon fossa four-cortex purchase lateral pinning in displaced supracondylar fracture of the humerus – a prospective analysis in 48 children

• Main Authors: Saravanan Kasirajan, Rajesh Govindasamy, Bhava Ramalingam Jawaharlal Sathish, Jimmy Joseph Meleppuram
• Format: Article
• Language: English
• Published: Sociedade Brasileira de Ortopedia e Traumatologia
• Series: Revista Brasileira de Ortopedia
• Subjects: Fraturas do úmero; Fixação de fraturas/interna; Processo olecraniano/lesões; Criança
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162018000300342&lng=en&tlng=en

ABSTRACT Objective The current study aims at a functional analysis of trans-olecranon lateral pinning for displaced supracondylar fracture of the humerus (SCFH) in children. Methods A prospective study of 48 children (30 males, 18 females; mean age: 7.4 years) with displaced SCFH was treated at this institution with modified technique from March 2011 to September 2014. Cases were selected on the basis of inclusion criteria. The functional outcome was assessed clinically by modified Flynn's criteria along with achievement of full range of motion. Results All 48 children with a mean follow up of 20 months (range: 6–26 months) were assessed. All fractures united well. With modified Flynn's criteria, results were excellent in 40 children (83.3%), good in six children (12.5%), and fair in two children (4.2%). There were no poor results. Preoperative nerve palsies seen in four children recovered at ten weeks. Full range of motion was achieved on an average of 20 days after K-wire removal and no new post-operative nerve palsies were noted. Conclusion The modified trans-olecranon fossa four-cortex purchase (TOF-FCP) technique was promising in all cases of unstable SCFH without the complications of loss of reduction or iatrogenic ulnar nerve injury. This technique is simple, safe, and reproducible, with good clinical results in this type of fracture.