How Safe Is the Operative Treatment of Gartland Type 2 Supracondylar Humerus Fractures in Children?

Skaggs, David L.; Sankar, Wudbhav N.; Albrektson, Josh; Vaishnav, Suketu; Choi, Paul D.; Kay, Robert M.

doi:10.1097/bpo.0b013e3181653ac8

Cited by 80 publications

(71 citation statements)

References 17 publications

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“…The average age of our patients was similar to that reported in other studies [3,11,32], thus confirming that the incidence of this injury peaks at 3-8 years of age [21]. With respect to the sex distribution, 59% were boys and 41% were girls, and this distribution was the same in both groups of treatments.…”

Section: Discussionsupporting

confidence: 91%

“…The treatment of type II fractures remains controversial. Whereas most authors prefer surgical treatment [3,8,11,12], others prefer orthopedic treatment [10,14,15]. However, there are few studies that compare the clinical and radiographic outcome with orthopedic or surgical treatment [12,15,16].…”

Section: Discussionmentioning

confidence: 97%

“…Most authors defend surgical treatment on the basis that maintenance of reduction is significantly improved with closed reduction and pinning. In addition, the risk of compartment syndrome, malunion, loss of reduction, stiffness, and residual deformities (cubitus varus or cubitus valgus) is increased with orthopedic treatment of these fractures [3,[11][12][13]. In contrast, other authors defend orthopedic treatment on the basis that closed reduction and casting yield good functional and radiographic results and do not lead to anesthetic complications and surgical complications such as iatrogenic neurovascular injury (ulnar nerve), pin-site, or bone infections and scars [10,[14][15][16].…”

Section: Introductionmentioning

confidence: 99%

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Orthopedic versus surgical treatment of Gartland type II supracondylar humerus fracture in children

Miranda

Sánchez-Arteaga

Marrachelli

et al. 2014

Journal of Pediatric Orthopaedics B

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The choice of orthopedic or surgical treatment for Gartland type II supracondylar humeral fractures remains controversial. The aim of this study was to retrospectively compare the outcomes in orthopedic and surgical treatment in type II supracondylar humeral fractures in children treated in the Orthopedic and Traumatology Children Unit of our tertiary hospital over the period between 2007 and 2010. This study suggests that orthopedic treatment is a valid option for the treatment of this type of fractures, with radiological and functional results as good as those obtained with surgical treatment, avoiding surgical complications and decreasing the hospital stay.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Orthopedic versus surgical treatment of Gartland type II supracondylar humerus fracture in children

Miranda

Sánchez-Arteaga

Marrachelli

et al. 2014

Journal of Pediatric Orthopaedics B

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“…Twelve to 13 weeks after surgery there was an average loss of 20°and 35°elbow motion in children with and without physical therapy, respectively. In contrast, Skaggs et al [19] observed that at a mean of 8.7 weeks after surgery, 92% (174 of 189) of patients had full ROM and only 1.6% (three of 189) of patients had loss of elbow motion of 10°or greater. However, their study included only Type 2 fractures according to the Wilkins' modification of the Gartland classification for supracondylar fractures of the humerus in children [21], whereas previous studies included Types 2 and 3 fractures.…”

Section: Introductionmentioning

confidence: 90%

Time of Return of Elbow Motion after Percutaneous Pinning of Pediatric Supracondylar Humerus Fractures

Zionts

Woodson

Manjra

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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The most common treatment for displaced pediatric supracondylar humerus fractures is closed reduction and percutaneous pinning. However, the time for return of elbow motion after treatment of these injuries is not well documented. To describe the return of elbow motion after closed reduction and percutaneous pinning of these fractures we retrospectively reviewed 63 patients (age range, 1.6-13.8 years) with displaced supracondylar fractures of the humerus stabilized with either two or three lateral entry pins. Pins were removed by 3 to 4 weeks. No patient participated in formal physical therapy. At each followup, elbow range of motion (ROM) was recorded for the injured and uninjured extremities. Elbow ROM returned to 72% of contralateral elbow motion by 6 weeks after pinning and progressively increased to 86% by 12 weeks, 94% by 26 weeks, and 98% by 52 weeks. After closed reduction and percutaneous pinning of a displaced, uncomplicated, supracondylar humerus fracture, 94% of the child's normal elbow ROM should be expected by 6 months after pinning. Further improvement may occur up to 1 year postoperatively. This information may be helpful in advising parents what to expect after their child's injury.

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“…Reduction of the contracture using two-level shortening osteotomy in the proximal and distal thirds of the forearm bones as a modified Colzi procedure can be a good option for ischemic contracture in certain cases [14]. Postoperative physiotherapy is important to improve residual limb function [15].…”

Section: Discussionmentioning

confidence: 99%

Volkmann Ischemic Contracture Due to Traditional Practice

Mahmood

Hussain

2008

Eur J Trauma Emerg Surg

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An 11-year-old boy presented with three days' history of blunt trauma to the left shoulder due to a fall to the ground. The boy was taken to the traditional practitioner, who applied a very tight bandage over a piece of cartoon on the upper left humerus, which resulted in progressive pain and swelling of the whole left upper limb and impairment of movement and sensation. The tight bandage was removed after 48 h and fasciotomy was performed at Aljamhuri Hospital in Taiz, Yemen. The child was brought to our hospital after the family was informed about the need for left forearm amputation. We performed four sessions of debridement of the dead muscles and soft tissues of the flexor and extensor compartments of the left upper limb. After three months, the left upper limb healed with fixed flexor contracture of the elbow and wrist joint. Manipulation and release of adhesions and subsequent skin grafting was performed and the elbow joint was kept in extension, the wrist in the neutral position, and the interphalangeal joints in flexion. Although the limb was saved, its aesthetic appearance was retained, and some sensation was achieved, the lost motor function of the forearm (including the hand) was irreversible.

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How Safe Is the Operative Treatment of Gartland Type 2 Supracondylar Humerus Fractures in Children?

Abstract: Therapeutic study, level 4 (case series [no or historical control group]).

Cited by 80 publications

References 17 publications

Orthopedic versus surgical treatment of Gartland type II supracondylar humerus fracture in children

Orthopedic versus surgical treatment of Gartland type II supracondylar humerus fracture in children

Time of Return of Elbow Motion after Percutaneous Pinning of Pediatric Supracondylar Humerus Fractures

Volkmann Ischemic Contracture Due to Traditional Practice

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