External fixation is not superior to K-wire fixation in pediatric patients with high-level extension-type supracondylar humeral fractures.

OBJECTIVES

Supracondylar humerus fractures (SHFs) are among the most common fractures in pediatric patients. The following two surgical options are available for high-level extension-type pediatric supracondylar humeral fractures: Kirschner wire (K-wire) fixation and lateral external fixation. Evidence comparing the clinical outcomes of these two procedures remains insufficient. This study aimed to compare functional and radiological outcomes between the two surgical approaches.

METHODS

This retrospective comparative study included 52 pediatric patients (15 treated with external fixation and 37 with K-wire fixation) with a minimum follow-up of 1 year. Outcome measures included open reduction rate, post-operative carrying angle, Baumann angle, humeral-capitellar angle, and complication rates (infection, ulnar nerve injury, and unacceptable cubitus varus). Elbow range of motion (ROM) was evaluated at serial follow-up points.

RESULTS

No ulnar nerve injury, major loss of reduction, pin-tract infection, or elbow stiffness occurred in either group. The only significant between-group difference was a lower open reduction rate in the external fixation group (P = 0.042). No statistically significant differences were observed in Baumann angle, humeral-capitellar angle, Flynn grade, carrying angle, or elbow ROM between the groups.

CONCLUSIONS

K-wire fixation and external fixation provide similarly satisfactory functional and radiological outcomes. External fixation offers no significant advantage over K-wire fixation for high-level extension-type supracondylar humeral fractures.