Surgical Treatment of Pediatric Supracondylar Humerus Fractures

Open reduction frequency was higher in older children (p=0.005).Conclusion:Closed reduction and fixation with 2 K wires (either cross fixation or divergent configuration) is an effective treatment, but for the older children, it is difficult to obtain anatomic fixation with closed reduction, therefore, we need three or more K wires to provide stable fixation

📌 3 Key Takeaways

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Objective & Hypothesis:Aim: The purpose of this study was to explore the frequency of pediatric supracondylar humerus fractures, and to determine the effects of age of on the number of pins used for osteosynthesis and the surgery techniques for reduction.Methods: 149 patients with Gartland type II and type III supracondylar humerus fractures, who were surgically treated in our clinic, were included in this study.

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Key Findings & Data:The subjects were divided into two groups according to the type of treatment (open versus closed reduction), and any correlation between the type of reduction and patients' age was investigated.Results: There was positive correlation between age and the total number of pins used (p=0.000).

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Conclusion & Impact:Open reduction frequency was higher in older children (p=0.005).Conclusion:Closed reduction and fixation with 2 K wires (either cross fixation or divergent configuration) is an effective treatment, but for the older children, it is difficult to obtain anatomic fixation with closed reduction, therefore, we need three or more K wires to provide stable fixation

🔬Design:Research Article

📍Scope:Comprehensive Sample

⚙️Variables:Domain Parameters

Abstract

Aim: The purpose of this study was to explore the frequency of pediatric supracondylar humerus fractures, and to determine the effects of age of on the number of pins used for osteosynthesis and the surgery techniques for reduction.Methods: 149 patients with Gartland type II and type III supracondylar humerus fractures, who were surgically treated in our clinic, were included in this study. The subjects were divided into two groups according to the type of treatment (open versus closed reduction), and any correlation between the type of reduction and patients' age was investigated.Results: There was positive correlation between age and the total number of pins used (p=0.000). Open reduction frequency was higher in older children (p=0.005).Conclusion:Closed reduction and fixation with 2 K wires (either cross fixation or divergent configuration) is an effective treatment, but for the older children, it is difficult to obtain anatomic fixation with closed reduction, therefore, we need three or more K wires to provide stable fixation

Özet

Amaç: Bu çalışmanın amacı pediatrik suprakondiler kırıkların sıklığını, artan yaşın cerrahi tedavi şekline ve kırık tespitinde kullanılan pin sayısına etkisini araştırmaktır.Yöntemler: Kliniğimizde opere edilmiş Gartland tip 2-3 suprakondiler humerus fraktürü olan 149 hasta çalışmaya dahil edildi. Hastalar açık ya da kapalı redüksiyon ile tedavi edilenler olarak gruplandırıldı ve bu grupların hasta yaşı ile ilişkisi incelendi. Bulgular: Hastaların yaşı ve kullanılan toplam pin sayısı arasındaki ilişkiye bakıldığı zaman yaş arttıkça kullanılan pin sayısındaki artış anlamlı bulundu (p=0.000). Hastaların yaşındaki artış ile açık redüksiyona duyulan ihtiyaçta artış olduğu görüldü (p=0.005). Sonuç: Gartland tip 2 veya 3 suprakondiler humerus kırıklarında kapalı redüksiyon ve çapraz ya da lateral kondilden yollanan diverjan 2 adet Kirschner teli etkin bir tedavidir. Hasta yaşı arttıkça hem kapalı redüksiyon şansımız hem de 2 adet Kirschner teli ile yeterli stabilite elde etme şansımız azalmaktadır.

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Cite This Article

BAYRAM, E., KAYA, İ., SUNGUR, İ., YILMAZ, M., ORDU, S., UĞRAŞ, A., ÇETİNUS, M. E. (2014). Surgical Treatment of Pediatric Supracondylar Humerus Fractures. Haseki Tıp Bülteni, Cilt: 52 - Sayı: 1, 43–46. https://ajindex.com/articles/267876

References (11)

Landin LA. Fracture patterns in children. Analysis of 8682 fractures with special reference to incidence, etiology and secular changes in a Swedish urban population 1950-1979. Acta Orthop Scand Suppl 1983;202:1-109.
Cheng JC, Lam TP, Shen WY. Closed reduction and percutaneous pinning for type III displaced supracondylar fractures of the humerus in children. J Orthop Trauma 1995;9:511-5.
Houshian S, Mehdi B, Larsen MS. The epidemiology of elbow fracture in children: analysis of 355 fractures, with special reference to supracondylar humerus fractures. J Orthop Sci 2001;6:312-5.
Heal J, Bould M, Livingstone J, Blewitt N, Blom AW. Reproducibility of the Gartland classification for supracondylar humeral fractures in children. J of Orthop Surg 2007;15:12-4.
McCarthy SM, Ogden JA. Radiology of postnatal skeletal development. V. Distal humerus. Skeletal Radiol 1982;7:239- 49. Re PR, Waters PM, Hresko T. T-condylar fractures of the distal humerus in children and adolescents. J Pediatr Orthop 1999;19:313-8.
Lee SS, Mahar AT, Miesen D, Newton PO. Displaced pediatric supracondylar humerus fractures: biomechanical analysis of percutaneous pinning techniques. J Pediatr Orthop 2002;22:440-3.
Herzenberg JE, Koreska J, Carrol NC, Rang M. Biomechanical testing of pin fixation techniques for pediatric supracondylar elbow fractures. Orthop Trans 1988;12:678-9. Silva M. Biomechanical Testing of Pin Configurations in Supracondylar Humeral Fractures: The Effect of Medial Column Comminution. J Orthop Trauma 2013;27:275-80.
Lee SS, Mahar AT, Miesen D, et al. Displaced pediatric supracondylar humerus fractures: Biomechanical analysis of percutaneous pinning techniques. J Pediatr Orthop 2002;22:440-3. Woratanarat P. Meta-analysis of pinning in supracondylar fracture of the humerus in children. J Orthop Trauma 2012;26:48-53. Skaggs DL. Operative treatment of supracondylar fractures of the humerus in children. The consequences of pin placement. J Bone Joint Surg Am 2001;83-A:735-40.
Flynn JC, Matthews JG, Benoit RL. Blind pinning of displaced supracondylar fractures of the humerus in children. Sixteen years' experience with long-term follow-up. J Bone Joint Surg Am 1974;56:263-72.
Turhan E, Aksoy C, Ege A, Bayar A, Keser S, Alpaslan M. Sagittal plane analysis of the open and closed methods in children with displaced supracondylar fractures of the humerus (a radiological study). Arch Orthop Trauma Surg 2008;128:739-44.
Ozkoc G, Gonc U, Kayaalp A, Teker K, Peker TT. Displaced supracondy