THE OUTCOME OF SUPRA-CONDYLER FRACTURES OF ELBOW JOINT MANAGED DURING ALTERED PERIODS OF TIME BY VARIOUS TECHNIQUES IN CHILDREN

Objective: To evaluate the results of supra-condyler fractures of elbow joint managed by various techniques to determine their complication in different hands and to generate attentiveness in public and treating doctor to highlight the complications and results of such injuries. Place and duration of the study: In the Orthopedic Unit II of Jinnah Hospital Lahore for one year duration from March 2019 to March 2020. Materials and methods: In this study, 247 patients were selected. Patients were divided into two groups; Group A consisted of 75 patients who were directly admitted to the hospital after the injury and were operated on 1-3 days after the injury. Group B (1) was divided into two groups, group B (1) was initially treated by quacks and after 10 to 15 days of injury were operated, group B (2) patients treated by comprehensive physical therapy, range of movement exercises and were conservatively managed after failure of treatment by quacks. A total of 120 patients underwent surgery and an open reduction with k wire fixation was performed, wire fixation was performed. All patients (247) were clinically and radiologically evaluated, with modified Gartland classification before and after surgery, using modified frayn’s criteria to assess the overall adequacy of supracondylar fractures. Results: 23 patients have compartment syndrome, 18 patients had surgery and 5 patients have refused for surgical intervention. Nine patients had gangrene located in the forearm, six were operated and amputation was performed on the above or below elbow, three patients refused surgery and went to another place / quacks for treatment. Complications were observed after various treatment regimens, including elbow joint stiffness and VIC; myositis, ossification, anterior and interosseous nerve damage, brachial artery spasm. The patient who developed post-traumatic neurological complications felt relief after treatment, and long-term complications were observed in patients who admitted after quacks treatment. Conclusion: Early surgical intervention gives excellent results. The results were disappointing when it was late because arm and elbow stiffness and infection were more likely due to a primary subclinical-infection due to a dirty seismic dressing. We noticed that there was no difference in postoperative radiography in terms of fracture reduction or a good result. In our opinion the soul reason illiteracy and failure of daily approach of parents who never follow doctor's instructions. That is why we recommend that doctors be aware of the importance of managing parents and patients by counselling, the consequences of such injuries and preventing complications. Key words: Operative technique, Supracondyler fracture, quack therapy