Abstract
Introduction Supracondylar fractures are common in children. Percutaneous K-wire fixation is an accepted standard treatment for displaced supracondylar fractures in children, but the ideal wire configuration remains controversial. This study aimed to review the radiographic outcome and complications of Gartland type II and type III supracondylar fractures treated by the crossed and lateral K-wire fixation. Methods Seventy-five cases were retrospectively reviewed, 41 and 34 in crossed and lateral K-wire fixation groups, respectively. We studied patient demographics, fracture characteristics, different operative variables, and complications between the two groups. Results No significant difference was noted in patient demographics and the size of the wire used between the two groups. More type III fractures were fixed with crossed wires, 31 vs. 15 (75% vs. 44%, p = 0.019). Higher open reduction was also noted in the crossed-wire group. Loss of reduction between the crossed and the lateral groups was not significantly different, 15 vs. 13 (36.6% vs. 38.2%). The crossed-wire group had more iatrogenic nerve injury than the lateral wire group, 9 vs. 1 (22% vs. 3%, p = 0.0185). Higher complications were observed in the crossed-wire group than in the lateral-wire group, mainly due to iatrogenic nerve injury, 19 vs. 5 (46.3% vs. 14.7%, p = 0.0052). Higher technical errors of wire fixation were noted with lateral wire fixation than with crossed-wire fixation, 28 vs. 12 (82% vs. 29%, p = 0.00001). Conclusions Higher complications were noted with crossed wires, primarily due to iatrogenic nerve injury. Between the crossed and lateral wire groups, there were no statistically significant differences in loss of reduction and other complications. We support lateral wiring with appropriate techniques in treating types II and III supracondylar fractures to avoid iatrogenic nerve injury and other complications.