Strategies in Trauma and Limb Reconstruction

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VOLUME 9 , ISSUE 2 ( August, 2014 ) > List of Articles

Original Article

Open reduction and pinning for the treatment of Gartland extension type III supracondylar humeral fractures in children

Mehmet Nuri Konya, Aykut Özdemir, Hüseyin Yorgancigil, Gökhan Maralcan, Emin Uysal

Keywords : Children, Humerus, Supracondylar fractures, Surgical approaches, Treatment results

Citation Information : Konya MN, Özdemir A, Yorgancigil H, Maralcan G, Uysal E. Open reduction and pinning for the treatment of Gartland extension type III supracondylar humeral fractures in children. 2014; 9 (2):79-88.

DOI: 10.1007/s11751-014-0198-7

License: CC BY-NC-SA 4.0

Published Online: 31-08-2014

Copyright Statement:  Copyright © 2014; The Author(s).


Abstract

In this study, we aim to evaluate the clinical and radiological results of children who were treated with four different surgical approaches. In our clinics between February 2004 and November 2012, the children who underwent surgical treatment for supracondylar humeral fractures and whose data were available with regular follow-up of at least 1 year were included in the study. Clinical outcomes were evaluated for 54 patients with Gartland type 3 extension supracondylar fractures. Functional and cosmetic results of the patients were determined according to the Flynn criteria. Mean age of the patients was 4.9 (between 2 and 14) among which 26 of them were girls and 28 were boys. Mean operation time was 45 (35–85) min. Average length of hospital stay (LHS) was 2.9 (1–7) days. Average duration of splints was 3.5 (2–6) weeks, while the average removal period of the wires was 4.6 (3–8) weeks. Mean consolidation time was 4.6 weeks (3–8). Mean follow-up was 14.36 months. In our study, we performed 54 patients functional and cosmetic results. While 48 of the patients had satisfying results (excellent, good, or fair), six of them had unsatisfactory (poor) results. The results of this study suggest that clinical results with surgical treatment of Gartland type 3 extension fractures were satisfactory. However, the delay in the surgical treatment may cause a number of complications.


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  1. Hasler CC (2001) Supracondylar fractures of the humerus in children. Eur J Trauma 1:338-353
  2. Cheng JC, Lam WY (1995) Closed reduction and percutaneous pinning for type 3 displaced supracondylar fractures of the humerus in children. J Orthop Trauma 9:511-515
  3. Flynn JC, Matthews JG, Benoýt RL (1974) Blind pinning of displaced supracondylar fractures of humerus in children. J Bone Joint Surg 56A:263-272
  4. Yousri T, Tarassoli P, Whitehouse M, Monsell F, Khan WS (2012) Systematic review of randomized controlled trials comparing efficacy of crossed versus lateral K-wire fixation in extension type Gartland type III supracondylar fractures of the humerus in children. Ortop Traumatol Rehabil 14(5):397-405
  5. Kasser JR, Beaty JH (2006). Supracondylar fractures of the distal humerus. In: Rockwood and Wilkins' fractures in children. 6th (ed.). Philadelphia, PA: Lippincott Williams&Wilkins. pp. 543-90
  6. Pretell-Mazzini J, Rodriguez-Martin J, Auñon-Martin I et al (2011) Controversial topics in the management of displaced supracondylar humerus fractures in children. Strategies Trauma Limb Reconstr 6:43-50
  7. Koudstaal MJ, De Ridder VA, De Lange S et al (2002) Pediatric supracondylar humerus fractures: the anterior approach. J Orthop Trauma 16:409-412
  8. Kumar R, Malhotra R (2000) Medial approach for operative treatment of the widely displaced supracondylar fractures of the humerus in children. J Orthop Surg (Hong Kong) 8:13-18
  9. Ay S, Akinci M, Kamiloglu S et al (2005) Open reduction of displaced pediatric supracondylar humeral fractures through the anterior cubital approach. J Pediatr Orthop 25:149-153
  10. Eren A, Özkut AT, Altýntaş F et al (2005) Comparison between the lateral and medial approaches in terms of functional and cosmetic results in the surgical treatment of type III supracondylar humeral fractures in children. Acta Orthop Traumatol Turc 39:199-204
  11. Pretell Mazzini J, Rodriguez Martin J, Andres Esteban EM (2010) Surgical approaches for open reduction and pinning in severely displaced supracondylar humerus fractures in children: a systematic review. J Child Orthop 4(2):52-143
  12. Longo UG, Franceschi F, Loppini M, Maffulli N, Denaro V (2008) Rating systems for evaluation of the elbow. Br Med Bull 87:131-161
  13. Mazda K, Boggione C, Fitoussi F et al (2001) Systematic pinning of displaced extension-type supracondylar fractures of the humerus in children. A prospective study of 116 consecutive patients. J Bone Joint Surg 83B:888-893
  14. Arcibeck MJ, Scott SM, Peters CL (1997) Brachialis muscle entrapment in displaced supracondylar humerus fractures: a technique of closed reduction and report of initial results. J Pediatr Orthop 17:298-302
  15. Gosens T, Bongers KJ (2003) Neurovascular complications and functional outcome in displaced supracondylar fractures of the humerus in children. Injury 34:267-273
  16. Pirone AM, Graham HK, Krajbıch JI (1988) Management of displaced extension type supracondylar fractures of the humerus in children. J Bone Joint Surg 70A:641-650
  17. Mehserle WL, Meehan PL (1991) Treatment of the displaced supracondylar fracture of the humerus (Type 3) with closed reduction and percutaneous cross-pin fixation. J Pediatr Orthop 11:705-711
  18. Mulhall KJ, Abuzakuk T, Curtin W et al (2000) Displaced supracondylar fractures of the humerus in children. Int Orthop 24:221-223
  19. Gordon JE, Patton CM, Luhmann SJ et al (2001) Fracture stability after pinning of displaced supracondylar distal humerus fractures in children. J Pediatr Orthop 21:313-318
  20. Karapınar L, Öztürk H, Altay T et al (2005) Closed reduction and percutaneous pinning with three Kirschner wires in children with type III displaced supracondylar fractures of the humerus. Acta Orthop Traumatol Turc 39:23-29
  21. Cekanauskas E, Degliüte R, Kalesinskas RJ (2003) Treatment of supracondylar humerus fractures in children, according to Gartland classification. Medicina 39:379-383
  22. Ippolito E, Catenm R, Scola E (1986) Supracondylar fractures of the humerus in children. J Bone Joint Surg 68A:333-344
  23. Aronson DD, Prager BI (1987) Supracondylar fractures of the humerus in children. Clin Orthop Relat Res 219:174-184
  24. Piggot J, Graham HK, McCoy GF (1986) Supracondylar fractures of the humerus in children. J Bone Joint Surg 68B:577-583
  25. Erdil M, İmren Y, Ceylan HH et al (2012) [Multiple neural injuries in a pediatric supracondylar humerus fracture]. J Clin Exp Invest 3:438-442
  26. Otsuka NY, Kasser JR (1997) Supracondylar fractures of humerus in children. J Am Acad Orthop Surg 5:19-26
  27. Sarğn S, Ahmet Aslan, Konya MN, Atik A, Meriç G (2013) Bonesetter choice of Turkish society in musculoskeletal injuries and the affecting factors. JCEI 4(4):477-482
  28. Ersan O, Gonen E, İlhan RD et al (2012) Comparison of anterior and lateral approaches in the treatment of extension-type supracondylar humerus fractures in children. J Pediatr Orthop B 21:121-126
  29. Millis MB, Smger IJ, Hail JE (1984) Supracondylar fractures of the humerus in children. Clin Orthop 188:90-97
  30. Ramsey RH, Gnz J (1973) Immediate open reduction and internal fixation of severely displaced supracondylar fractures of the humerus in children. Clin Orthop Relat Res 90:130-132
  31. Kazimoglu C, Cetin M, Sener M, Aguş H, Kalanderer O (2009) Operative management of type III extension supracondylar fractures in children. Int Orthop 33(4):1089-1094
  32. Kurer MHJ, Regan MW (1990) Completely displaced supracondylar fracture of the humerus in children. Clin Orthop Relat Res 256:205-214
  33. Gennari JM, Merrot T, Piclet B et al (1998) Anterior approach versus posterior approach to surgical treatment of children's supracondylar fractures: comparative study of thirty cases in each series. J Pediatr Orthop B 7:307-313
  34. Kabukçuoğlu Y, Öztürk L, Bulut G et al (1993) [The treatment of supracondylar fractures in children by open reduction]. Acta Orhop Traumatol Turc 27:243-247
  35. Jones KG (1967) Percutaneous pin fixation of fractures of the lower end of the humerus. Clin Orthop Relat Res 50:53-69
  36. D'ambrosıa RD (1972) Supracondylar fractures of humerus. prevention of cubitus varus. J Bone Joint Surg 54A:60-66
  37. Ağuş H, Kalenderer Ö, Kayalı C (1999) Closed reduction and percutaneous pinning results in children with supracondylar humerus fractures. Acta Orhop Traumatol Turc 33:18-22
  38. Yıldırım AO, Unal VS, Oken OF et al (2009) Timing of surgical treatment for type III supracondylar humerus fractures in pediatric patients. J Child Orthop 3:265-269
  39. Tiwari A, Kanojia RK, Kapoor SK (2007) Surgical management for late presentation of supracondylar humeral fracture in children. J Orthop Surg (Hong Kong) 15:177-182
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