Management of Supracondylar Humerus Fractures in Children: Current Concepts

Is Lateral Pin Fixation for Displaced Supracondylar Fractures of the Humerus Better Than Crossed Pins in Children?

“…The pooled result of iatrogenic ulnar nerve injury in the current study is in agreement with previous reviews [1,3,5,38,40,52]. Babal et al [3] performed a meta-analysis which was derived almost exclusively from retrospective studies and concluded that the medial pin carried the greater overall risk of nerve injury as compared with a lateral-pin-only construct, and that the ulnar nerve was at risk of injury in patients who had medial pins.…”

Emergency or Delayed Surgical Treatment of Unstable Supracondylar Humeral Fractures in Children?

“…Patients from group I had significantly better results one year after operation than patients from group II. (15). Fracture is more common in boys (Table 1); this is explained by the fact that boys are more restless than girls (16).…”

Classifications In Brief: The Gartland Classification of Supracondylar Humerus Fractures

“…Treatment of pediatric supracondylar humerus fractures has evolved since Gartland's first description [12]; however, current treatment recommendations from the American Academy of Orthopaedic Surgeons remain based on the modified Gartland classification [2,10,21]. Type I injuries are immobilized with a cast for 3 to 4 weeks, with radiographic alignment checked at 1 week.…”

“…Types III and IV Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. injuries also are treated with closed reduction and percutaneous pinning, as are flexion-type injuries, with possible open reduction and internal fixation if closed reduction is unsuccessful [2]. Treatment details, such as the number of pins, medial versus lateral pin placement, requirement to observe and protect the ulnar nerve with medial pin placement, and construct biomechanical stability have been discussed [2].…”

“…injuries also are treated with closed reduction and percutaneous pinning, as are flexion-type injuries, with possible open reduction and internal fixation if closed reduction is unsuccessful [2]. Treatment details, such as the number of pins, medial versus lateral pin placement, requirement to observe and protect the ulnar nerve with medial pin placement, and construct biomechanical stability have been discussed [2]. Open reduction-lateral, medial, or anterior approach-is indicated for an open fracture when irrigation and débridement are needed, when a closed reduction is unsuccessful, and for treatment of fractures associated with a dysvascular limb (pulseless, not pink hand) [21].…”