ArticlePloS one2026
Differences in postoperative complications and elbow function between K-wire fixation of Gartland Wilkins type 2 and 3 supracondylar humeral fractures in children.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAlthough the pathophysiology of Gartland Wilkins type 2 (GW 2) and 3 (GW 3) fractures is comparable, there are distinctive nuances regarding anatomical compromise and fracture stability. These differences may imply unique trajectories of functional rehabilitation, radiological outcomes and reduction-related complications, but consequential differences in treatment outcomes have not been studied thoroughly. GOAL: To describe complications after K-wire fixation of supracondylar humeral fractures in children, and identify differences in postoperative outcomes between GW2 and GW3 fractures following K-wire fixation.
methodsA retrospective single-center cohort study was conducted. Children below 16 years of age that underwent K-wire fixation of a supracondylar fracture between January 2013 and October 2023 were identified. Patient characteristics, functional and radiological outcomes and postoperative complications were collected and compared between patients with GW 2 and GW 3 fractures.
resultsA total of 178 patients were included in the analyses, of which 14.0% had a postoperative complication. The GW grade 3 group had a shorter time between trauma and surgery (p < 0.001), a longer time between surgery and K-wire removal (34.5 versus 31.7 days, p = 0.008) and a longer time between surgery and cast removal (34.9 versus 32.8 days, p = 0.017) than the GW grade 2 group. The GW-grade 3 group had a significantly lower rate of closed reduction than the GW-grade 2 group (48.4% versus 77.1%, p < 0.001). The GW3 group had a significantly higher rate of complications than the GW2 group (21.1% versus 6.0%, p = 0.005). This was mainly due to a higher rate of loss of reduction (0.0% versus 9.5%, p = 0.004). Rates of infection, nerve damage and chronic pain were also higher in the GW3 group, although not significant.
conclusionIn this cohort, 14.0% of all patients had a postoperative complication. GW3 fractures treated with K-wires were found to have significantly more complications than GW2 fractures. Also, the rate of loss of reduction was significantly higher in the GW3 group.
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