# Clinical study on closed Kirschner wire prying reduction for Gartland Type IV supracondylar humeral fractures in children and analysis of typical cases

## TL;DR

This study shows that a minimally invasive technique using Kirschner wires can safely and effectively treat a specific type of elbow fracture in children.

## Contribution

The study demonstrates the clinical effectiveness of closed Kirschner wire prying reduction for Gartland Type IV fractures in children.

## Key findings

- 22 out of 24 children achieved successful reduction without open surgery.
- The average operation time was 42 minutes, with 86.4% excellent or good functional outcomes.
- Postoperative imaging showed good alignment and full elbow joint recovery in typical cases.

## Abstract

To explore the feasibility, safety and clinical efficacy of closed Kirschner wire prying reduction technique in the treatment of Gartland Type IV supracondylar humeral fractures in children.

A retrospective analysis was conducted on the clinical data of 24 children with intraoperatively confirmed Gartland Type IV supracondylar humeral fractures admitted to Gannan Prefecture People's Hospital from January 2018 to May 2025. After the failure of closed manual reduction, all children underwent closed reduction using percutaneous Kirschner wire prying technique, followed by cross or double lateral Kirschner wire fixation. The operation time, reduction success rate, occurrence of complications and postoperative functional recovery were collected. In addition, 2 representative cases were selected to display typical imaging data.

Among the 24 children, 22 achieved successful reduction without open surgery; the average operation time was 42 min. One child had mild re-displacement after surgery, and one child had transient ulnar nerve palsy. All cases achieved good fracture healing, and the excellent and good rate of Flynn score at the last follow-up was 86.4%. The postoperative imaging of typical cases showed good alignment, and the elbow joint function was completely restored.

For children with Gartland Type IV supracondylar humeral fractures, closed Kirschner wire prying reduction technique is a safe and effective minimally invasive reduction method, which may effectively reduce the need for open reduction, and has good clinical application value.