Advertisement
Paper| Volume 22, ISSUE 4, P259-262, July 1991

Download started.

Ok

Management of displaced supracondylar fractures of the humerus in children

      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      A series of 33 children with displaced supracondylar fractures of the humerus (SFH) were all treated operatively by open reduction and internal fixation or by closed reduction and percutaneous pinning. A follow-up study was performed on average 29 months (range 3–63 months) after the injury. In 18 per cent of cases primary neurovascular injury was observed and confirmed at operation. Of these patients 32 had open reduction and internal fixation by K-wires; in only one case was closed reduction and percutaneous pinning attempted. If there was preoperative neurological deficit, the nerves were visualized; however nerve suture was not required in our series. In one case we had to reconstruct both the brachial and radial arteries because of intimal lesions totally occluding the vessels. The average hospital stay was 9 days, including pin removal which was usually performed about 4–5 weeks later, at the time of plaster removal.
      By Innocenti's criteria, 27 of 30 patients reviewed had an excellent result; three had a good result and three patients were lost to follow-up. There were no complications due to the operation, such as wound healing problems, infections or nerve lesions. In the light of our experience and of the good results, we recommend that displaced SFH be managed by open reduction and internal K-wire fixation. Percutaneous pinning is a good alternative method when closed reduction is successful at the first attempt.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Injury
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Aronson D.D.
        • Prager B.I.
        Supracondylar fractures of the humerus in children, a modified technique for closed pinning.
        Clin. Orthop. 1951; 219: 174
        • Blount W.P.
        • Schultz I.
        Fractures of the elbow in children.
        JAMA. 1951; 146: 699
        • Dallek M.
        • Mommsen U.
        • Jungbluth K.H.
        • et al.
        Die supracondyläre Humerusfraktur im Kindesalter, ihre Behandlung und Ergebnisse nach der Methode von Blount.
        Unfallchirurgie. 1985; 11: 192
        • Flynn J.C.
        • Matthews J.G.
        • Benoit R.L.
        Blind pinning of displaced supracondylar fractures of the humerus in children. Sixteen years' experience with long-term follow-up.
        J. Bone Joint Surg. 1974; 56A: 263
        • Gartland J.J.
        Management of supracondylar fractures of the humerus in children.
        Surg. Gynecol. Obstet. 1959; 109: 145
        • Kramhoft M.
        • Keller I.L.
        • Solgard S.
        Displaced supracondylar fractures of the humerus in children.
        Clin. Orthop. 1987; 221: 215
        • Mark G.
        • Innocenti M.
        • Rüedi Th.
        • et al.
        Die supracondyläre Humerusfraktur beim Kind.
        Helv. Chir. Acta. 1984; 51: 617
        • Piggot J.
        • Graham H.K.
        • McCoy G.F.
        Supracondylar fractures of the humerus in children. Treatment by straight lateral traction.
        J. Bone Joint Surg. 1986; 68B: 557
        • Pirone A.M.
        • Graham H.K.
        • Krajbich J.I.
        Management of displaced extension-type supracondylar fractures of the humerus in children.
        J. Bone Joint Surg. 1988; 70A: 641
        • Schütz W.
        • Börner M.
        Indikation zur operativen und konservativen Behandlung der kindlichen suprakondylären Oberarmfrakturen sowie deren Ergebnisse.
        Unfallchirurgie. 1985; 11: 17
        • Sigge W.
        • Behrens K.
        • Roggenkamp K.
        • et al.
        Vergleich von Blountscher Schlinge und Kirschner-Drahtfixation zur Behandlung der dislozierten supracondylären Humerusfraktur im Kindesalter.
        Unfallchirurgie. 1987; 13: 82
        • Wilkins K.E.
        Fractures and dislocations of the elbow region.
        in: Fracture in Children. Vol. 3. J. B. Lippincott, Philadelphia1984: 363