Functional Outcome of Percutaneous Pining in Gartland Type III Supracondylar Humerus Fractures

Authors

  • Abdul Khaliq Langove Chief Medical Officer / Postgraduate Student (PGMI), Bolan Medical College, Quetta, Pakistan Author
  • Iftikhar ul Haq Former Head of Department, Orthopedic, Bolan Medical College, Quetta, Pakistan Author
  • Muhammad Bakhsh Shahwani Head of Department, Orthopedic, Bolan Medical College, Quetta, Pakistan Author
  • Khawand Bakhsh Assistant Professor, Department of Orthopedic, Bolan Medical College, Quetta, Pakistan Author

DOI:

https://doi.org/10.61919/nktd5349

Keywords:

Closed Reduction, Percutaneous Pinning, Gartland Type III, Supracondylar Humerus Fracture, Pediatric Orthopedics, Functional Outcome

Abstract

Background: Supracondylar fractures of the humerus are the most common pediatric elbow injuries, accounting for nearly two-thirds of cases, with Gartland type III representing the most displaced and unstable form. Traditional management with casting or traction has been associated with high rates of malunion, stiffness, and deformity, whereas surgical fixation using closed reduction and percutaneous pinning has emerged as the preferred technique due to superior stability and functional recovery. However, local data from resource-limited healthcare settings remain sparse, underscoring the need for outcome-based evaluations. Objective: To determine the functional outcomes of closed reduction and percutaneous pinning in children with Gartland type III supracondylar humerus fractures. Methods: This descriptive case series was conducted at Bolan Medical Complex Hospital, Quetta, Pakistan, from August 2020 to February 2021. Sixty-one children aged 2–12 years with Gartland type III fractures were managed using closed reduction and percutaneous cross-pinning under general anesthesia. Outcomes were assessed prospectively at three months using Flynn’s criteria, measuring loss of carrying angle and loss of flexion/extension against the contralateral limb. Data were analyzed using SPSS version 16.0 with descriptive and inferential statistics applied. Results: The mean age was 6.9 ± 1.8 years; 80.5% were male, and 70.4% had left-sided fractures. At three months, range of motion outcomes were excellent in 41%, good in 29.5%, fair in 20%, and poor in 9.5%, while cosmetic carrying angle outcomes were excellent in 42.6%, good in 32.7%, fair in 21.3%, and poor in 3.3%. Statistical analysis showed significant improvements in both domains (p < 0.01). Conclusion: Closed reduction and percutaneous pinning provide effective functional and cosmetic recovery in pediatric Gartland type III supracondylar humerus fractures, supporting its role as the treatment of choice in centers with operative facilities. Longer follow-up and multicenter comparative studies are recommended to further validate safety and long-term outcomes.

 

References

1. Qayyum N. What to Do With Gartland Type III Supracondylar Fractures of Humerus in Children: Study of 84 Patients. J Pak Orthop Assoc. 2008;20(1):71-5.

2. Canale ST, Beaty JH, editors. Campbell’s Operative Orthopaedics. 11th ed. Philadelphia: Mosby Elsevier; 2008. p.1581-2.

3. Bruhacher S, Dodds S. Pediatric Supracondylar Fractures of the Distal Humerus. Curr Rev Musculoskelet Med. 2008;1(3-4):190-6.

4. Tariq MA, Ali A, Shafi M. Supracondylar Fractures: Comparison of Medial and Lateral Approach for Fixation of Humerus in Children. Prof Med J. 2006;13:244-52.

5. Ahmad I, Durrani Z. Management of Displaced Supracondylar Fracture of Humerus in Children With Side Arm Traction. Pak J Surg. 2006;22:159-61.

6. Shoaib M, Sultan S, Sahibzada SA, Ali A. Percutaneous Pinning in Displaced Supracondylar Fracture of Humerus in Children. J Ayub Med Coll Abbottabad. 2004;16:48-50.

7. Ali WA, Said MA, Boghdady G, Ali A. Results of Treatment of Displaced Supracondylar Humerus Fractures in Children by Percutaneous Lateral Cross-Wiring Technique. Strategies Trauma Limb Reconstr. 2008;3(1):1-7.

8. Suh SW, Oh CW, Shingade VU, Swapnil MK, Park BC, Lee SH, et al. Minimally Invasive Surgical Techniques for Irreducible Supracondylar Fractures of the Humerus in Children. Acta Orthop. 2005;76:862-6.

9. Rijal KP, Pandey BK. Supracondylar Extension Type III Fracture of the Humerus in Children: Percutaneous Cross-Pinning. Kathmandu Univ Med J. 2006;4:465-9.

10. Coulon G, Ceroni D, Rosa V, Pazos JM, Kaelin A. Nonoperative Treatment of Displaced Supracondylar Fractures in Children. Acta Orthop. 2005;76:858-61.

11. Nikolic H, Bukvic N, Tomasic Z, Bosak A, Cicvaric T. Bone Remodeling After Supracondylar Humeral Fracture in Children. Coll Antropol. 2014;38:601-4.

12. Harris IE. Supracondylar Fractures of the Humerus in Children. Orthopedics. 1992;15:811-7.

13. Kasser JR, Beaty JH, editors. Supracondylar Humerus Fractures. In: Rockwood and Wilkins’ Fractures in Children. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2001. p.563-624.

14. Yaokreh JB, Gicquel P, Schneider L, Stanchina C, Karger C, Saliba E, et al. Compared Outcomes After Percutaneous Pinning Versus Open Reduction in Paediatric Supracondylar Elbow Fractures. Orthop Traumatol Surg Res. 2012;98(6):645-51.

15. Pirone AM, Graham HK, Krajbich JI. Management of Displaced Extension-Type Supracondylar Fractures of the Humerus in Children. J Bone Joint Surg Am. 1988;70:641-50.

16. France J, Strong M. Deformity and Function in Supracondylar Fractures of the Humerus in Children Variously Treated by Closed Reduction and Splinting, Traction, and Percutaneous Pinning. J Pediatr Orthop. 1992;2:494-8.

Downloads

Published

2024-12-31

Issue

Section

Articles

How to Cite

1.
Abdul Khaliq Langove, Iftikhar ul Haq, Muhammad Bakhsh Shahwani, Khawand Bakhsh. Functional Outcome of Percutaneous Pining in Gartland Type III Supracondylar Humerus Fractures. JHWCR [Internet]. 2024 Dec. 31 [cited 2025 Sep. 27];:e796. Available from: https://jhwcr.com/index.php/jhwcr/article/view/796