Indikation zur operativen und konservativen Behandlung der kindlichen suprakondylären Oberarmfrakturen sowie deren Ergebnisse

Abstract

In the period from 1977 to 1982 78 children were treated for supracondylar fractures of the humerus at the Berufsgenossenschaftliche Unfallklinik Frankfurt/Main. Indications and methods for operative and conservative treatment are described. The results of therapy were reviewed by means of a questionnaire or reexamination in 68 patients with regard to function, elbow deformity and nerve lesions. Fractures of a grade I severity are to be treated conservatively by immobilisation in a POP-cast. Only in exceptional cases of grade II severity can a closed reduction be recommended. All remaining types of fractures of grade II and III severity should primarily be treated by open operations within 8 hours of the accident. Under these conditions the risk of infection is no higher than with percutaneous Kirschner-wire-osteosynthesis. Complications such as appreciable varus deformity, poor function and nerve lesions can largely be avoided in this way. The so-called extension-treatment offers no advantages in comparison with operative treatment.

Treatment of Supra- and Percondylar Fractures of the Humerus in Children: Consequences for Management from a Retrospective Analysis of 137 Cases

“…Most authors [13,17,18,25] recommend open reduction and Kirschner wire osteosynthesis in fractures of Grade III dislocation. In Grade II dislocated fractures with a severe axial kink, malrotation, primary nerve or tissue involvement, they prefer closed reduction with Kirschner wire fixation, primarily because of the gentle reduction that can be precisely controlled from an anatomic viewpoint, the effective prevention of rotational malpositioning, and the evacuation of the fracture hematoma.…”