Classifications In Brief: The Gartland Classification of Supracondylar Humerus Fractures

Alton, Timothy B.; Werner, Shawn; Gee, Albert O.

doi:10.1007/s11999-014-4033-8

Cited by 65 publications

(78 citation statements)

References 26 publications

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“…The commonly accepted definition of significant coronal plane malalignment is change of >128 in Baumann angle [18] and the failure of the anterior humeral line to intersect the capitellum's physis was considered as loss of sagittal plane reduction, similar to Gartland classification [19]. After analysis of our data we feel that the Baumann angle was not a reliable parameter in assessing postoperative alignment in a splinted, flexed elbow.…”

Section: Discussionmentioning

confidence: 75%

The outcome of early revision of malaligned pediatric supracondylar humerus fractures

Weil

Simanovsky

et al. 2015

Injury

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Section: Discussionmentioning

confidence: 75%

The outcome of early revision of malaligned pediatric supracondylar humerus fractures

Weil

Simanovsky

et al. 2015

Injury

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“…The most common cause of flexion-type SHF in children is a direct fall on the elbow, which results in failure of the posterior cortex and thus anterior angulation of the distal fragment [4]. Flexion-type fractures are classified as extension-type fractures according to Gartland classification system as nondisplaced, partially displaced, and completely displaced [8,9]. The treatment of flexion-type fractures can be either: 1) closed reduction under anesthesia by traction, correction of displacement and angulation and stabilization with a long arm cast in 20° of elbow-flexion, 2) closed reduction and percutaneous pinning or 3) open reduction and percutaneous pinning [10].…”

Section: Discussionmentioning

confidence: 99%

Flexion-Type Supracondylar Humeral Fracture with Ulnar Nerve Injury in Children: Two Case Reports and Review of the Literature

et al. 2020

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Rare co-existance of disease or pathology Background: Supracondylar humeral fracture is a common fracture in the pediatric population. Although extension-type is the most common fracture pattern (97% to 98%), flexion-type supracondylar fractures are rarely encountered (2% to 3%). The combination of a flexion-type supracondylar humeral fracture with an ulnar nerve injury represents a real challenge for an orthopaedic surgeon. Case Reports: We report 2 cases of flexion-type supracondylar humeral fracture with ulnar nerve injury that open reduction and fixation was necessary because closed reduction could not achieve an acceptable result. An anterior approach to the elbow joint was chosen to explore whether any neurovascular structures were entrapped between the fragments. The ulnar nerve was not found to be compressed in the fracture site. After anatomic reduction, cross K-wire fixation of the fracture was performed. At 6-month follow-up, ulnar nerve injuries (in both patients) were resolved. Conclusions: These case reports enhance the existing literature that flexion-type supracondylar fractures with ulnar nerve injury are associated with higher rates of open reduction. Orthopaedic surgeons should be aware, and family members of those patients should be informed, that the likelihood of an open reduction in these types of injuries is extremely high. Open reduction is needed not only to achieve an anatomic reduction of the fracture but to make sure that the ulnar nerve is not entrapped between the proximal and distal fragment.

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“…3,14 É a classificação mais utilizada, com alta concordância intraobservador e interobservador (►Figura 1). 1,3 Tipo I: sem desvio, ou minimamente desviada (< 2 mm). O periósteo íntegro em toda a circunferência mantém a estabilidade.…”

Section: Classificaçãounclassified

“…1,4 Tipo III: desvio completo, sem contato entre as corticais, com maior risco de lesões neurovasculares e interposição de partes moles. 3,11 São fraturas instáveis e geralmente de difícil redução. Porém, o periósteo posterior parcialmente preservado ajuda na redução e estabilização da fratura quando o cotovelo é fletido, facilitando a fixação.…”

Section: Classificaçãounclassified

Manejo da fratura supracondiliana do úmero na criança

Poggiali

Nogueira

2020

Rev Bras Ortop (Sao Paulo)

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ResumoA fratura supracondiliana do úmero representa cerca de 3 a 15% de todas as fraturas na criança, sendo a que mais requer tratamento cirúrgico na população pediátrica. Apesar de os avanços no tratamento e na assistência terem contribuído para uma redução drástica da complicação mais temida, a contratura isquêmica de Volkmann, os riscos inerentes à fratura permanecem. Ausência de pulso palpável em fraturas tipo III é reportada em até 20% dos casos. Uma cuidadosa avaliação sensitiva, motora e vascular do membro acometido é fundamental na determinação da urgência do tratamento. Crianças mais velhas, sexo masculino, cotovelo flutuante, e lesão neurovascular são fatores de risco para a síndrome de compartimento. A cominuição medial pode levar à consolidação em varo, mesmo nos casos aparentemente inocentes. O método de escolha para o tratamento da fratura desviada é a redução fechada e fixação percutânea. Os erros na fixação e posicionamento inadequado dos implantes são as principais causas de perda de redução. Já existem evidências suficientes para a utilização de um terceiro fio de Kirschner, lateral ou medial, nas fraturas instáveis (tipo III e IV). Baseado nos conceitos atuais, um fluxograma para o tratamento da fratura supracondiliana do úmero na criança é sugerido pelos autores.

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Classifications In Brief: The Gartland Classification of Supracondylar Humerus Fractures

Cited by 65 publications

References 26 publications

The outcome of early revision of malaligned pediatric supracondylar humerus fractures

The outcome of early revision of malaligned pediatric supracondylar humerus fractures

Flexion-Type Supracondylar Humeral Fracture with Ulnar Nerve Injury in Children: Two Case Reports and Review of the Literature

Manejo da fratura supracondiliana do úmero na criança

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