Long term results of children with supracondylar humeral fractures treated with manipulation and strapping and manipulation followed by pin fixation were evaluated.
Forty patients were regarded as Gartland type II injuries. 33 of these were treated with closed reduction and collar and cuff immobilisation and 7 with closed reduction and percutaneous pinning. Two cases of cubitus varus were reported one from each treatment modality
Forty-four patients were included as Gartland type III injuries. Of these 14 were treated with closed reduction and collar and cuff immobilisation, 25 with closed reduction and percutaneous pinning and five with open reduction and pinning. There were two cases of cubitus varus and one case of cubitus valgus following pin fixation. In addition one case of extension lag and one significant ulnar nerve neurapraxia was recorded following pin fixation. One case of cubitus varus was seen following manipulation and collar and cuff treatment.
There was no statistical difference between either treatment modality in terms of predicting a better outcome (p>0.05).
We conclude that pin fixation has no advantages over simple immobilisation in certain Gartland II and III type injuries. Although pin fixation is beneficial in unstable injuries collar and cuff immobilisation continues to have an important role in the treatment of stable supracondylar fractures.
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
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Limb fracture patterns in different paediatric age groups; a study of 3,350 children.J. Orthop. Trauma. 1993; 7: 15-22
- Supracondylar fractures of the humerus in children.J. Am. Acad. Orthop. Surg. 1997; 5: 19-26
- Management of displaced extension type supracondylar fractures of the humerus in children.J. Bone Joint Surg. (Am). 1988; 70: 641-650
- Operative management of upper extremity fractures in children. American Academy of Orthopaedic Surgeons monograph series. 1994
- Management of supracondylar fractures of the humerus in children.Surg. Gynecol. Obstet. 1959; 109: 145-154
- Prevention of Cubitus varus deformity in supracondylar fractures of the humerus.Injury. 1991; 22: 202-206
- Blind pinning of displaced supracondylar fractures of the humerus in children. Sixteen years of experience with long-term follow up.J. Bone Joint Surg. (Am). 1974; 56: 263-272
- Supracondylar fractures of the humerus in children: further experience in orthopaedic decision making.Clin. Orthop. 1984; 188: 90-97
- Supracondylar fractures of the humerus in children: a modified technique for closed pinning.Clin. Orthop. 1987; 219: 174-184
- Difficult supracondylar elbow fractures of the humerus in children; analysis of percutaneous pinning technique.J. Paediatr. Orthop. 1992; 12: 16-19
- Management of displaced supracondylar fractures of the humerus in children.Injury. 1991; 22: 259-262
- Treatment of the displaced supracondylar fracture of the humerus with closed reduction and percutaneous cross fixation.J. Peadiatr. Orthop. 1991; 11: 705-711
- The management of severely displaced supracondylar fractures of the humerus.Techniques Orthop. 1989; 4: 5-24
- Percutaneous fixation of supracondylar fractures of the humerus in children.J. Bone and Joint Surg. (Am). 1977; 59: 914-916
- Traumatic and iatrogenic neurological complications after supracondylar humeral fractures in children.J. Paediatr. Orthop. 1995; 15: 440-443
- Neurovascular injury and displacement in type III supracondylar humeral fractures.J. Paediatr. Orthop. 1995; 15: 47-52
- Ulnar nerve palsy; a complication following percutaneous fixation of supracondylar fractures of the humerus in children.Injury. 1996; 27: 303-305
- Treatment of selected supracondylar fractures of the humerus by manipulation and strapping in flexion.Injury. 1993; 24: 249-252
- A selective treatment approach to supracondylar fracture of the humerus in children.J. Paediatr. Orthop. 1996; 16: 104-106
- The operative management of supracondylar fractures.Orthop. Clin. North Am. 1990; 21: 269-289
- Displaced supracondylar fractures of the humerus in children treated by overhead olecranon traction.Injury. 1984; 15: 316-321
Accepted: October 19, 1999
© 2000 Elsevier Science Ltd. Published by Elsevier Inc. All rights reserved.