SUPRACONDYLAR FRACTURES OF THE HUMERUS IN CHILDREN - TECHNIQUE AND RESULTS OF CROSSED PERCUTANEOUS K-WIRE FIXATION

Displaced extension type supracondylar fractures of the humerus are as sociated with neurovascular injuries and malunion (cubitus varus). Red uction is not usually difficult during the first few hours, but it is a problem to maintain. After reduction, the shoulder is placed in abdu ction external-rotation with the elbow flexed under the C-arm. This po sition locks the proximal segment of the fracture, and the posteromedi ally rotated distal segment can then be brought back into an anatomic position under the ''medial pillar.'' In this position, an excellent l ateral view is obtained and the ''fish tail'' deformation can be corre cted. Crossed percutaneous K-wires are introduced to maintain reductio n. An anteroposterior radiograph can then be freely obtained, and ther e is no need for hyperflexion at the elbow. Twenty-six children were t reated between 1987 and 1992. Excellent results were obtained.