A clinical study of surgical management of paediatric humeral supracondylar fracture
Keywords:Supracondylar fracture, Fracture humerus, Open reduction, Internal fixation, K wire
Background: Injury to the supracondylar region of the humerus and complete displacement of the fragments occurs in many of the cases when children usually fall while playing. This is most common fracture seen in children, makes up to 60% of all elbow injuries. Early intervention results in excellent reduction and avoids complications. Concomitant vascular and nerve damages may occur. Open reduction and internal fixation is a helpful option for the treatment of supracondylar facture of humerus in children.
Methods: Forty children who presented with displaced supracondylar fracture of the humerus were treated with open reduction and internal fixation with Kirschner (K) wires after thorough pre-operative investigation during the course of the study. Children below the age of 13 were selected irrespective of the sex.
Results: Good results were obtained in 60% of the patients, fair in 30% and poor in 10%. The poor results were due to the open fracture and in two cases the patient presented very late to the hospital. Complications such as nerve injuries, vascular injuries, infections were noticed in the study. Four patients had cubitus varus and twelve patients had flexion loss on follow-up study.
Conclusions: Open reduction and internal fixation with K wire is an easy, simple, inexpensive method, which has good outcome.
Boyd HB, Attenberg AR. Fractures about the elbow in children. Arch Surg. 1944;49:213.
Hanlon CR, Ester WL. Fractures in children: a statistical analysis. Am J Surg. 1954;87:312.
Mitchell WJ, Adam JP. Supracondylar fractures in children. JAMA. 1961;175:573-7.
Weiland AJ, Baltimore SM, Vernon LTT. Surgical treatment of displaced Supracondylar fractures of humerus in children. J Bone Joint Surg. 1978;60:657.
Ambrosia D. Supracondylar fractures of the humerus-prevention of varus deformity. J Bone Joint Surg. 1972;54:60.
Fowles JV, Kassab MT. Displaced fractures of the elbow in children. J Bone Joint Surg. 1974;56:490-500
Krurer MH, Regan MW. Completely displaced Supracondylar fractures of the humerus in children. Clin Orthop. 1990;256:205-14.
Flynn JC, Mathews JG, Benot RL. Blind Pinning of displaced Supracondylar fractures of humerus in children. J Bone Joint Surg. 1974;56A:163.
Smith L. Deformity following supracondylar fractures of humerus in children. J Bone Joint Surg. 1960;42:245.
Gruber, Hudson OC. Supracondylar fractures of humerus in children: end result study of open reduction. J Bone Joint Surg. 1964;46:1245.
Sandegard E. Fractures of lower and end of humerus in children treatment and end results. Acta Chir Scand. 1944;89-116.
Ramsey RH, Griz. J. Immediate open reduction and internal fixation of severely displaced supracondylar fractures of the humerus in children. Clin Orthop. 1973;90:130.
Holmberg L. Fractures in children. Acta Chir Scand. 1945;103.