Evaluation of the Effectiveness of Closed Reduction and Percutaneous Pinning Versus Open Reduction for Grade III Supracondylar Humeral Fractures in Children in Kano

Grade III supracondylar humeral fractures in children represent the most severe subtype, carrying the highest risk of neurovascular compromise and elbow malunion. The debate between closed reduction and percutaneous Kirschner wire pinning (CRPP) and open reduction and internal fixation (ORIF) for these injuries in low-resource settings remains clinically significant. This randomised controlled study compares the outcomes of CRPP and ORIF in Gartland III supracondylar humeral fractures in children under twelve years presenting at Aminu Kano Teaching Hospital (AKTH), North West Nigeria. Sixty-four eligible patients will be randomised to each group. Outcomes assessed at three and six months will include time to union, Baumann angle maintenance, Flynn criteria classification (excellent, good, fair, poor), incidence of iatrogenic nerve injury, wound infection, and Volkmann ischaemic contracture. Operating time and post-operative hospital stay will also be compared. The study hypothesises that CRPP achieves equivalent functional results to ORIF with fewer complications in experienced hands. This trial contributes high-quality randomised evidence on paediatric supracondylar fracture management in North West Nigeria, a setting where the surgical evidence base is primarily observational. Findings will inform local and national paediatric orthopaedic management guidelines and contribute to international comparative data. Keywords: supracondylar fracture, CRPP, ORIF, paediatric orthopaedics, Kano.