Crossed versus Lateral K‑Wire Fixation for Supracondylar Humeral Fractures in Children: Comparative Outcomes at Tripoli Central Hospital (2023–2025)

• Mahmoud Ali

  Orthopaedic Department, Tripoli Central Hospital, Tripoli, Libya

  Author

• Abdurrezag Said

  Orthopaedic Department, Tripoli Central Hospital, Tripoli, Libya

  Author

• Khawlah Alghzawi

  Orthopaedic Department, Tripoli Central Hospital, Tripoli, Libya

  Author

• Israa Elkhoja

  Orthopaedic Department, Tripoli Central Hospital, Tripoli, Libya

  Author

• Sara Morgham

  Orthopaedic Department, Tripoli Central Hospital, Tripoli, Libya

  Author

• Sondis Hasan

  Orthopaedic Department, Tripoli Central Hospital, Tripoli, Libya

  Author

• Mofida Fathi

  Orthopaedic Department, Tripoli Central Hospital, Tripoli, Libya

  Author

• Ritaj Agha

  Orthopaedic Department, Tripoli Central Hospital, Tripoli, Libya

  Author

• Karima Morgham

  Orthopaedic Department, Tripoli Central Hospital, Tripoli, Libya

  Author

Supracondylar fractures of the humerus (SFH) account for about 3 to 15% of all bone lesions affecting the immature skeleton, especially in children under seven years of age. In general, these lesions are treated with closed reduction and percutaneous fixation using Kirschner wires (KW). This study aimed to assess crossed versus lateral K-wire fixation for supracondylar fractures of the Humerus in children (outcome comparison) at Tripoli Central Hospital, 2023-2025. This retrospective randomized control trial study was conducted at the orthopedics department of Tripoli Central Hospital between January 2023 and October 2025. This study included children who suffered from supracondylar fractures of the Humerus. It was managed by crossed versus lateral K-wire fixation, and the data were collected via simple random techniques through a standardized, predesigned structural questionnaire during that time interval. The collected data were entered, encoded, and analyzed via the specialized statistical program of SPSS version 24. Sixty (60) children with supracondylar humerus fractures were treated with crossed K-wires (30 cases) or lateral K-wire fixation (30 cases). The mean age was 4.716 years ± 1.132 SD, with a minimum age of three and a maximum age of seven years. 58.3% (35) of the cases were males, while 41.7% (25) were females. Only 6.7% (4) of the cases had a previous history of trauma. All cases had closed fractures, with 51.7% (31) at the right supracondylar and 48.3% (29) at the left supracondylar. The mean duration of fracture was 6.63 hours ± 4.971 SD. The majority of cases had Gartland’s type 3 fracture, accounting for 70.0% (42), while 30.0% (18) had Gartland’s type 2 fracture. Only 8.3% (5) experienced wound infection, and 3.3% (2) experienced weakness. Significant statistical differences were found between crossed and lateral K-wires regarding complications, with a P-value of 0.021. The study revealed that crossed K-wires had more complications, including weakness (neuropraxia) in 4 cases and wound infection in 2 cases, compared to lateral K-wires, which had only 1 case of wound infection. About 56.7% (34) of the cases experienced swelling, and 3.3% (2) had other associated fractures, but all cases had favorable functional and operative outcomes. In summary, this study concluded that lateral K-wire management of supracondylar fracture among the pediatric age group had better functional and operational outcomes with a lower rate of postoperative complications compared to crossed K-wire, which was found to have more complications, such as weakness (neuropraxia) and wound infection. Therefore, proper assessment of supracondylar fracture cases is an essential approach to achieve optimal management outcomes.

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