Functional Outcome of Percutaneous Pining in Gartland Type III Supracondylar Humerus Fractures

Abstract

Background: Supracondylar fractures of the humerus are the most common pediatric elbow injuries, accounting for nearly two-thirds of cases, with Gartland type III representing the most displaced and unstable form. Traditional management with casting or traction has been associated with high rates of malunion, stiffness, and deformity, whereas surgical fixation using closed reduction and percutaneous pinning has emerged as the preferred technique due to superior stability and functional recovery. However, local data from resource-limited healthcare settings remain sparse, underscoring the need for outcome-based evaluations. Objective: To determine the functional outcomes of closed reduction and percutaneous pinning in children with Gartland type III supracondylar humerus fractures. Methods: This descriptive case series was conducted at Bolan Medical Complex Hospital, Quetta, Pakistan, from August 2020 to February 2021. Sixty-one children aged 2–12 years with Gartland type III fractures were managed using closed reduction and percutaneous cross-pinning under general anesthesia. Outcomes were assessed prospectively at three months using Flynn’s criteria, measuring loss of carrying angle and loss of flexion/extension against the contralateral limb. Data were analyzed using SPSS version 16.0 with descriptive and inferential statistics applied. Results: The mean age was 6.9 ± 1.8 years; 80.5% were male, and 70.4% had left-sided fractures. At three months, range of motion outcomes were excellent in 41%, good in 29.5%, fair in 20%, and poor in 9.5%, while cosmetic carrying angle outcomes were excellent in 42.6%, good in 32.7%, fair in 21.3%, and poor in 3.3%. Statistical analysis showed significant improvements in both domains (p < 0.01). Conclusion: Closed reduction and percutaneous pinning provide effective functional and cosmetic recovery in pediatric Gartland type III supracondylar humerus fractures, supporting its role as the treatment of choice in centers with operative facilities. Longer follow-up and multicenter comparative studies are recommended to further validate safety and long-term outcomes.