Comparison of Upper Elbow Cast and Splint in Type II Supracondylar Humerus Fractures in Pediatric Patients

Bayram, Erhan; Aydın, Mahmud; Ersin, Mehmet; Ekinci, Mehmet; Yıldırım, Cem; Yılmaz, Murat

doi:10.4274/haseki.galenos.2021.6369

Cited by 2 publications

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“…According to these studies, factors that were identified to predict secondary displacement or influence the decision to perform CRPP are the degree of fracture extension, soft tissue condition, rotational deformity, varus malalignment, valgus malignment, and not using sedation. The details of these studies are shown in Table 4 [4,[7][8][9][10][11][12][13]15,18,[20][21][22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

“…The shaft condylar angle (SCA) difference of less than 18° is classified as type IIA [4]. Many surgeons advocated closed reduction (CR) and casting as a treatment for a minimally displaced type II fracture (or type IIA) with good results [5][6][7][8][9][10][11][12][13]. On the other hand, others preferred CRPP for a more severe type II fracture (or type IIB).…”

Section: Introductionmentioning

confidence: 99%

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Is subclassification of Gartland extension-type pediatric supracondylar fracture into types IIA and IIB necessary for treatment decision? A result of pediatric orthopedist’s survey and review of literature

Tangadulrat

Adulkasem

Suganjanasate

et al. 2022

Journal of Pediatric Orthopaedics B

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Extension-type pediatric supracondylar humeral fractures are very common. The Gartland classification is typically used to guide treatment. However, there is still no consensus on what factors should be used to subclassify the type II fractures and whether subclassification is needed to guide treatment. Therefore, we aim to explore the opinions of pediatric orthopedists on the treatment method of the Gartland type II supracondylar fracture. Specifically, we ask what factors are considered for their treatment decisions and whether subclassification is needed to guide treatment. An online questionnaire was developed and sent to the Thai Paediatric Orthopedics Society and Asia-Pacific Paediatric Orthopaedic Society members. The results were analyzed to explore the relationship between respondents' demographic factors and treatment decisions. Out of 113 participants reached, 57 (50.4%) responded to the questionnaire. Factors chosen by respondents are stability testing intraoperatively (73.7%), the relationship of the anterior humeral line and capitellum (66.7%), the presence of rotation (50.9%), the presence of translation (47.4%), the presence of medial comminution 42.1%), soft tissue condition(38.6%), the shaft -condylar angle (31.6%), and the Bauman angle (21.1%). Thirty-three of 57 respondents (57.9%) deemed subclassification for Gartland type II necessary for guiding treatment. About half of respondents in our study deemed the current Gartland type II subclassification necessary to guide treatment, which may indicate that the subclassification might not be sufficiently comprehensive and reliable. Therefore, better criteria for a subclassification and a prospective evaluating study might be needed.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Is subclassification of Gartland extension-type pediatric supracondylar fracture into types IIA and IIB necessary for treatment decision? A result of pediatric orthopedist’s survey and review of literature

Tangadulrat

Adulkasem

Suganjanasate

et al. 2022

Journal of Pediatric Orthopaedics B

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Examining Outcomes and Complications for Operative Versus Nonoperative Treatment of Pediatric Type II Supracondylar Humerus Fractures: A Systematic Review of Comparative Studies

Baumann,

Anaspure,

Patel

et al. 2024

Journal of Pediatric Orthopaedics

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Objective: The optimal management of pediatric type II supracondylar humerus fractures (SCHFs) is debated. We conducted a systematic review comparing outcomes and complications of nonoperative versus operative management to aid decision-making and inform future research. Methods: We searched PubMed, Web of Science, MEDLINE, and CINAHL from their inception until February 7, 2024, including studies on pediatric patients (<18 y) with any type II SCHF, provided they compared operative to nonoperative care and were in English. The quality of articles was evaluated using the Methodological Index for Non-Randomized Studies Scale. Results: Out of 417 studies reviewed, 7 met the inclusion criteria. These studies involved 1446 patients (mean age: 4.9 y; mean follow-up: 5.0 mo), comparing operative (n = 427) and nonoperative (n = 1019) treatments. Functional outcomes such as carrying angle, Baumann angle, elbow range-of-motion, and patient satisfaction were similar across treatment groups. Nonoperative management showed a higher incidence of residual sagittal deformity (14.1% vs 0.0%; P < 0.0001) and a treatment failure rate of 8.9% to 20.6%, necessitating surgical intervention. Factors prompting operative care included rotational deformity, varus/valgus misalignment, and a shaft-condylar angle below 30 degrees. Conclusion: Nonoperative treatment of type II SCHF is linked with higher rates of residual sagittal deformity and a notable failure rate requiring subsequent surgery. Both treatment strategies showed similar functional outcomes and patient satisfaction. Further research should focus on identifying anatomic criteria predictive of nonoperative treatment failure. Level of Evidence: Level III—systematic review.

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Comparison of Upper Elbow Cast and Splint in Type II Supracondylar Humerus Fractures in Pediatric Patients

Cited by 2 publications

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Is subclassification of Gartland extension-type pediatric supracondylar fracture into types IIA and IIB necessary for treatment decision? A result of pediatric orthopedist’s survey and review of literature

Is subclassification of Gartland extension-type pediatric supracondylar fracture into types IIA and IIB necessary for treatment decision? A result of pediatric orthopedist’s survey and review of literature

Examining Outcomes and Complications for Operative Versus Nonoperative Treatment of Pediatric Type II Supracondylar Humerus Fractures: A Systematic Review of Comparative Studies

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