FUNCTIONAL OUTCOME OF SUPRACONDYLAR FRACTURES OF HUMERUS IN CHILDREN UNDERGOING DORGAN’S SURGICAL TECHNIQUE
DOI:
https://doi.org/10.71000/e3n4r250Keywords:
Supracondylar humerus fracture, Dorgan’s technique, pediatric orthopedics, Mayo Elbow Performance Score, percutaneous pinning, surgical fixation, treatment outcomeAbstract
Background: Supracondylar fractures of the humerus are among the most common pediatric elbow injuries, typically occurring in children aged 5 to 7 years. Prompt and effective management is crucial to prevent long-term functional impairment. Dorgan’s lateral cross pinning technique, introduced to avoid ulnar nerve injury associated with traditional medial-lateral pinning, offers a potentially safer and biomechanically stable alternative. Despite its clinical utility, local evidence on its outcomes remains limited, warranting further evaluation in institutional settings.
Objective: To determine the functional outcome of supracondylar fractures of the humerus in children treated with Dorgan’s surgical technique at a tertiary care center.
Methods: A descriptive study was conducted from 01 November 2024 to 01 May 2025 at the Department of Orthopedic Surgery, Combined Military Hospital, Peshawar. Ninety children aged 5 to 15 years with radiographically confirmed supracondylar humerus fractures were enrolled through consecutive non-probability sampling. All patients underwent closed reduction followed by percutaneous fixation using Dorgan’s technique. Postoperative immobilization was provided with an above-elbow cast. Functional outcomes were assessed at 60 days using the Mayo Elbow Performance Score (MEPS), categorized as excellent (90–100), good (75–89), fair (60–74), or poor (<60). Data were analyzed using SPSS v21.
Results: The mean age was 9.12 ± 3.05 years, and the mean weight was 31.96 ± 11.69 kg. Males comprised 61.1% (n=55) and females 38.9% (n=35). Functional outcomes were excellent in 76.7% (n=69), good in 16.7% (n=15), and fair in 6.7% (n=6). No poor outcomes were reported. Complications included infection in 12.2% (n=11) and malunion in 3.3% (n=3).
Conclusion: Dorgan’s lateral-entry technique demonstrated high efficacy with excellent functional outcomes and low complication rates, supporting its use as a safe and effective approach for pediatric supracondylar humerus fractures.
References
Spierenburg W, Dekker ABE, Doornberg JN, Krijnen P, van den Bekerom MPJ, Schipper IB. Agreement on fixation of pediatric supracondylar humerus fractures. Eur J Trauma Emerg Surg. 2022;48(5):4277-82.
Scherer S, Dietzel M, Jordan N, Tsiflikas I, Kirschner HJ, Fuchs J, et al. Changes in the management of pediatric medial humeral epicondyle fractures with and without associated elbow dislocation. Injury. 2021;52(8):2257-64.
Stelmach W, Beczkowski J, Zając P, Małecki K, Sibiński M, Niedzielski K. Clinical and radiological evaluation of surgical treatment of medial epicondyle fractures of humerus in children. A two-centre study. Sci Rep. 2023;13(1):10095.
Piggott RP, Hennessy O, Aresti NA. Distal humerus hemiarthroplasty for trauma: a systematic review of the outcomes and complications. J Shoulder Elbow Surg. 2022;31(7):1545-52.
Sommerfeldt DW, Schmittenbecher PP. Failure analysis and recommendations for treatment of posttraumatic non-unions of the distal humerus during childhood. Eur J Trauma Emerg Surg. 2021;47(2):313-24.
Fernandez FF, Ihle C, Ziegler P, Wirth T, Eberhardt O. Fractures of the Humeral Ulnar Condyle in Children - a Rare but Complicated Injury. Z Orthop Unfall. 2022;160(2):190-7.
Khanfour AA. Long-standing Nonunited Fracture Lateral Humeral Condyle in Children. Evaluating a Two-stage Surgical Treatment Strategy With Critical Review. J Pediatr Orthop. 2024;44(5):e426-e32.
Dai J, Zhang W, Zou C, Yu G, Zhao T, Chen M, et al. Neural wedge osteotomy method of correction for cubitus varus deformity in children. Medicine (Baltimore). 2022;101(34):e30074.
Yang L, Xia F, Guo JC, Wang XL, He JP, Shao JF. Nonunion of humeral medial condyle fracture caused by excessive functional exercise: a case report and review of the literature. BMC Musculoskelet Disord. 2022;23(1):964.
Yang L, Yang P, Li L, Tang X. The outcome of loose bone fragments in pediatric supracondylar humerus fractures: a retrospective study. J Pediatr Orthop B. 2022;31(1):12-7.
Kassai T, Varga M, Józsa G. Pediatric medial humeral epicondyle fracture in children: Are biodegradable pins with tension band absorbable sutures efficient? Medicine (Baltimore). 2022;101(30):e29817.
Wang Q, Wang Y, He M, Cao H, Zhao J. Research: Construction and validation of elbow function prediction model after supracondylar humerus fracture in children. Medicine (Baltimore). 2023;102(52):e36775.
Zhang S, Tan SHS, Lim AKS, Hui JHP. Surgical outcomes in paediatric lateral condyle non-union: A systematic review and meta-analysis. Orthop Traumatol Surg Res. 2022;108(1):102933.
Ducic S, Stojanovic B, Lazovic M, Bukva B, Radlovic V, Bumbasirevic V, et al. T-condylar humerus fracture in children: treatment options and outcomes. Int Orthop. 2021;45(4):1065-70.
May CC, Abzug JM. Transphyseal Fracture of the Distal Humerus. Instr Course Lect. 2024;73:427-34.
Micheloni GM, Novi M, Leigheb M, Giorgini A, Porcellini G, Tarallo L. Supracondylar fractures in children: management and treatment. Acta Bio Medica: Atenei Parmensis. 2021;92(3): e2021015.
Duffy S, Flannery O, Gelfer Y, Monsell F. Overview of the contemporary management of supracondylar humeral fractures in children. European Journal of orthopaedic surgery & traumatology. 2021; 31:871-81.
Durusoy S, Öner K, Özer A, Sevinç HF. The effect of the angle between fracture line and Kirschner wires on stability in supracondylar humerus fractures treated with Kirschner wire fixation: A finite element analysis. Jt Disand Reld Surg. 2021;32(1):75.
Ikram MA, Shahzad H, Gnanou JV. Iatrogenic ulnar nerve palsy associated with supracondylar humeral fracture in children: A systemic review on its management. Trauma. 2024;26(3):201-9.
Khan MW, Irfan SA, Waseem R, Hussain MS, Sultan SM, Aftab A, et al. Unlocking Safer Outcomes: A Meta-Analysis Comparing Dorgan's Lateral Cross-Pinning and Traditional Mediolateral Pinning in Pediatric Supracondylar Fractures. Res Square; 2024.
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Copyright (c) 2025 Muhammad Bilal Khan, Muhammad Ejaz Ashraf (Author)
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