Functional outcome of displaced (gartland type III) supracondylar humerus fractures in children treated by closed reduction and percutaneous kirschner wire fixation: a prospective observational study

Background: Displaced (Gartland type III) supracondylar humerus fractures in children risk malunion and neurovascular complications. Closed reduction and percutaneous K-wire fixation is widely regarded as standard treatment, however Indian tertiary-centre data are limited. We evaluated the functional and cosmetic outcomes and complications of this procedure. Methods: This prospective observational study was conducted at a tertiary care centre, BMCRC Ballari, India; from June 2023 to December 2024, 50 children aged 3–13 years with closed, completely displaced supracondylar fractures underwent closed reduction and percutaneous K-wire fixation under C-arm guidance (crossed pins, n=40; two lateral pins, n=10), then an above-elbow slab application for three weeks. Outcome was graded by Flynn’s criteria. Results: Mean age was 8.0±2.5 years; 68% were boys and 64% had left-sided injuries. Median time to surgery was 1 day and mean hospital stay 2.6 days. Outcome was excellent in 36 (72%), good in 9 (18%) and fair in 5 (10%); none was poor (satisfactory 100%, 95% CI 92.9–100). Mean loss of motion was 5.4° and of carrying angle 1.9°. Five patients (10%) had complications such as ulnar nerve palsy in 2 (both after crossed pinning; full recovery by two months), K-wire migration in 2 and superficial pin-tract infection in 1. No cubitus varus was recorded. Conclusions: Closed reduction and percutaneous K-wire fixation gave satisfactory outcomes in all 50 children with few, mostly minor complications. Ulnar nerve injury occurred only after crossed pinning, supporting lateral-entry pinning when adequate stability can be achieved without a medial pin.