Radiographic Assessment in the Treatment of Supracondylar Humerus Fractures in Children

Abstract

Introduction:Supracondylar humerus fractures are the most common fractures of the humerus at the elbow in children. The key role belongs to the age and immaturity of the humerus region. Treatment, even today represents the problem of bone and joint surgery. Gartland classification divides these fractures into four types. Analysis of radiographic parameters will serve as an indicator for treatment selection.Goal:To demonstrate the role of radiographic evaluation by measurement of default radiographic parameters and indicate the choice of treatment for supracondylar fractures of type I and II by Gartland.Material and methods:The study included 60 children aged 4-14 years, divided into two groups, first with initial radiographic analysis and the second one without radiographic analysis. All were treated at the Primary Health Care Center Novi Travnik and Nova Bila Hospital from 2009 to 2011. Analysis was performed using methods of descriptive statistics to calculate the mean and standard deviation, Student’s t-test and Chi-square test.Results:In patients from first group hospitalization, immobilization duration, as well as physical treatment was shorter and more frequently surgical treatment was applied (manual reduction with K-wire fixation) with statistically significant difference (p = 0.042).Conclusion:Radiographic evaluation is one way to choose methods of fracture treatment. The incidence of complications is low, with excellent outcome of treatment and a faster return of children to their daily activities.

Comparison of clinic-radiological outcome of cross pinning versus lateral pinning for displaced supracondylar fracture of humerus in children: A randomized controlled trial

“…Controversy persists regarding the optimal pin fixation technique 11 Although many configuration of pinning is described in the literature, the two most commonly used configurations are crossed and lateral entry pinning. 5,12 There is a significant risk of iatrogenic ulnar nerve injury during medial pinning in crossed configuration with incidence rate of 0e6%. 13 Whereas, in lateral pinning technique, there is a chance of loss of reduction due to biomechanically less stable, and most common complication of poor or loss of reduction during treatment is cubitus varus with the incidence of 3e57%.…”

What is the best fixation technique for the treatment of supracondylar humerus fractures in children?

“…Closed reduction and pinning stabilization is the most commonly used technique. 9 , 10 Fixation can be performed with crossed pins 8 or lateral pins. 4 A mini-open technique is an option for medial passage.…”

Application of ultrasound in the management of TRASH (the radiographic appearance seemed harmless) fractures in preschool children: A review

“…The general standards for elbow fracture diagnosis include the Baumann angle, lateral humeral line, and humerocondylar angle on X-ray films. [9–11] On radiographs, the transphyseal separation of the distal humerus appears as dislocation-like (Salter-Harris type I) (Fig. 2) or dislocation-like with a metaphyseal fragment slice (Salter-Harris type II) as described by Delee.…”