Management of Displaced Supracondylar Fractures of the Humerus Using Lateral vs. Crossed K-wires

University of British Columbia

Status: Completed

Conditions: Humeral Fractures

Treatments: Procedure: Lateral K-wiring of supracondylar fracture of the humerus; Procedure: Crossed K-wiring of supracondylar fracture of the humerus

Study type: Interventional

Funder types: Other

Identifiers

NCT00358787

W04-0180

H04-70532

Details and patient eligibility

About

Completely displaced (Type III) supracondylar fractures of the humerus are treated in the operating room and are held together with pins stuck into the bone. There are two ways of inserting the pins: crossed and laterally. The crossed method is often used because it is thought to be more stable, but this method also carries a risk of hitting the ulnar nerve. It is not known which method is more stable. Our hypothesis is that loss of reduction will be equivalent between the two pinning methods.

Full description

Children with type III supracondylar fractures of humerus who meet the study inclusion criteria will be invited to participate in the study by the on call orthopaedic surgeon. All patients will be required to provide informed consent. Patients will then be randomized through a random number software package and will commence immediately after confirmation of inclusion into the study. The fracture is reduced and fixed percutaneously either with crossed or lateral K wires, according to which group the subject was randomized to. Post reduction antero-posterior and lateral radiographs of the elbow are done in the operating room. Above elbow cast is applied. Radiographs are taken at follow-up visits to the clinic. The radiographs are measured to determine loss of reduction between immediate post-op films and films taken immediately prior to pin removal.

Enrollment: 55 patients

Sex: All

Ages: 3 to 7 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Male and female patients scheduled for closed reduction and K wiring of supracondylar fractures of the humerus under general anaesthesia a
• Type-3 Supracondylar fractures of the humerus.
• Aged 3 to 7 years old
• Consent to participate in the study

Exclusion criteria

• Open supracondylar fractures of the humerus
• Children with pre-operative ulnar nerve injury
• Supracondylar fractures with compartment syndrome needing fasciotomy
• Supracondylar fractures needing vascular repair
• Refusal to provide informed consent

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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55 participants in 2 patient groups

1

Active Comparator group

Description:

Crossed K wire orientation for surgical management of a type III Supracondylar fracture.

Treatment:

Procedure: Crossed K-wiring of supracondylar fracture of the humerus

2

Active Comparator group

Description:

Lateral K wire orientation for surgical management of a type III Supracondylar fracture.

Treatment:

Procedure: Lateral K-wiring of supracondylar fracture of the humerus