Completely displaced supracondylar humerus fractures in children:results of open reduction versus closed reduction

Oh, Chang-Wug; Park, Byung‐Chul; Kim, Poong-Taek; Park, Il-Hyung; Kyung, Hee-Soo; Ihn, Joo-Chul

doi:10.1007/s007760300023

Cited by 56 publications

(43 citation statements)

References 16 publications

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“…Conversely, this has been disproved by many studies recently. [2][3][4][5] The rate of conversion to open reduction has been reported previously from as low as 3% to as high as 40% 4,[11][12][13][14][15] and in our series, the overall rate was 34%. In our study, there was a higher trend of open reduction when these fractures were managed early (41%) than when operated on later (25%) although this was not statistically significant (p=0.1).…”

Section: Discussionsupporting

confidence: 65%

Managing supracondylar fractures of the distal humerus in children in a district general hospital

Pullagura

Odak

Pratt

2013

annals

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INTRODUCTION Controversy exists regarding the timing of surgery in children with displaced supracondylar fractures of the humerus. METHODS We reviewed retrospectively the postoperative outcomes and complications in these children managed in a district general hospital. RESULTS There were 81 children with displaced supracondylar fractures (64 Gartland type III and 17 type IIA). Of these, 46 children were treated within 6 hours of presentation and 35 were treated later. The rate of open reduction was higher in children treated early (23%) than in late cases (11%). There was no significant difference in the postoperative outcomes and complications between the groups. CONCLUSIONS In children with a supracondylar fracture, the timing of surgical treatment (before or after six hours from presentation to hospital) had no effect on postoperative complications and outcomes.

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Section: Discussionsupporting

confidence: 65%

Managing supracondylar fractures of the distal humerus in children in a district general hospital

Pullagura

Odak

Pratt

2013

annals

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“…There is no definitive treatment for Gartland type III supracondylar fractures. Proponents of closed reduction with percutaneous pinning state that fewer complications such as infection and loss of movement occur with closed reduction [12,13]. Also the hospital stay is reduced.…”

Section: Discussionmentioning

confidence: 99%

“…Many methods have been recommended for the treatment of type III fractures including closed reduction and cast immobilisation, traction by various methods and reduction via closed or open means and fixation by Kirschner (K-) wires [1,[11][12][13][14][15]. The aim of this study was to evaluate the outcomes of two different treatment options (primarily closed reduction and percutaneous pinning versus primarily open reduction with pinning) for type III extension fractures performed at two different institutes.…”

Section: Introductionmentioning

confidence: 99%

Operative management of type III extension supracondylar fractures in children

Kazımoğlu

Çetin

Şener

et al. 2008

International Orthopaedics (SICOT)

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The purpose of this study was to compare primarily open versus primarily closed surgical treatment of Gartland type III extension supracondylar fractures in children. Also the outcomes of different pinning techniques in open surgery were evaluated retrospectively. Eighty displaced type III extension supracondylar fractures treated consecutively at two different centres were included. The treatment protocol of one institute was primarily closed reduction and percutaneous cross-pinning (n=43). The treatment protocol of the other institute was primarily open reduction and internal fixation (n=37) with two lateral parallel pins (n=11), cross pins (n=11) and two lateral and one medial pin (n=15) according to the stability and configuration of the fracture. According to Flynn's criteria the outcomes of the open and closed reduction groups were not statistically significant (P>0.05). Although the outcomes of closed reduction showed no superiority over open reduction, it should be the first choice of treatment due to its low morbidity and short hospital stay.

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“…Although irreducible fractures are uncommon (mostly due to interposition of the brachialis muscle, median nerve, and brachial artery [20]), 2-12% require open reduction [27,34]. Surgical exposure can be accomplished by a variety of approaches [21,[35][36][37].…”

Section: Introductionmentioning

confidence: 99%

Surgical approaches for open reduction and pinning in severely displaced supracondylar humerus fractures in children: A systematic review

Mazzini

Martín

Esteban

2010

Journal of Children's Orthopaedics

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Purpose There is no clear evidence in the actual literature regarding which of the surgical approaches could bring about the best functional, cosmetic, and radiological outcomes, as well as fewer complications, when an open reduction and pinning of a severely displaced supracondylar humerus fracture is performed. We, therefore, performed a systematic review of the English literature to investigate the existing evidence regarding this issue. Methods A MEDLINE and EMBASE databases search was performed to identify articles that focused on the functional, cosmetic, and radiological outcomes, as well as post-surgical complications, regarding different surgical approaches used for open reduction and pinning in severely displaced supracondylar humerus fractures in children. One hundred and ninety-four articles were identified, of which seven were included for review. Data analysis included weighted means for all contingency tables and the Chi-square test. Standardized residues were studied when the Chi-square test was statistically significant. Statistical analyses were conducted using Stata 9.1/SE (StataCorp., College Station, TX) and P-values lower than 0.05 were considered to be statistically significant for all analyses. Results For functional outcome, a high frequency of excellent results was found within the lateral and medial approaches, and a high frequency of good results within the anterior approach. A high frequency of poor results was found within the posterior approach. For cosmetic outcome, there was a high frequency of fair results within the posterior and lateral approaches, and a high frequency of poor results within the posterior approach. No statistically significant difference regarding time to union, as well as complications, was found. Conclusion Our results suggest that a combined anteromedial approach could be the method which allows the achievement of better functional and cosmetic outcome according to Flynn's criteria. Time to union, as well as post-surgical complications, should not be an issue regarding surgical approaches used for open reduction and pinning in these fractures.

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Completely displaced supracondylar humerus fractures in children:results of open reduction versus closed reduction

Cited by 56 publications

References 16 publications

Managing supracondylar fractures of the distal humerus in children in a district general hospital

Managing supracondylar fractures of the distal humerus in children in a district general hospital

Operative management of type III extension supracondylar fractures in children

Surgical approaches for open reduction and pinning in severely displaced supracondylar humerus fractures in children: A systematic review

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