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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.
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References
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Article info
Publication history
Accepted:
November 17,
1990
Identification
Copyright
© 1991 Published by Elsevier Inc.
