Functional Outcomes of Treatment of Paediatric Supracondylar Fractures With Open or Closed Reduction and Crossed Kirschner Wire (K-wire) Fixation

Background: Supracondylar fractures of the humerus are a common type of elbow injury in children, and there is ongoing debate about the best method of surgical fixation. Objectives: The aim of this study was to assess the functional outcome of paediatric supracondylar fractures managed using crossed Kirschner wire (K-wire) fixation. Methods: This was a retrospective observational study. Thirty-one children (one to 14 years) with displaced supracondylar humerus fracture (Gartland types 2 and 3) treated with closed or open reduction and crossed K-wire fixation were included. Those with undisplaced fractures, flexion-type supracondylar fractures, open fractures, associated ipsilateral limb fractures, previous ipsilateral elbow injury, or neurovascular injury on presentation were excluded from the study. All patients were followed up for a period of one year, and functional outcome was evaluated using the Mayo Elbow Performance Score (MEPS). Results: The mean age of the study population was 6.2 years (range: one to 14 years; SD: 3.6), with the majority of patients (51.6%) in the five- to nine-year age group. All fractures were of the extension type. Twenty-three patients (74.2%) sustained Gartland type III fractures, and eight patients (25.8%) had Gartland type II fractures. At the one-year follow-up, as evaluated by the MEPS, excellent functional outcomes were observed in 27 patients (87.1%), good outcomes in two patients (6.4%), and fair outcomes in two patients (6.4%). No individuals exhibited poor outcomes. Additionally, no cases of iatrogenic nerve injury, malunion, or residual deformity were noted at final follow-up. Conclusion: Surgical fixation of supracondylar fractures with cross-pinning is an effective and safe modality for treating displaced paediatric supracondylar humerus fractures. When performed by an experienced surgeon using a mini-open medial approach, the risk of iatrogenic nerve injury is minimal. Large-scale prospective studies are required to further validate these findings.